His Majesty's Ship [________]

[________]18[__]

Sir,

Please to supply His Majesty's Ship [________] with the under-mentioned Fresh Provisions for Victualling

[________] Sick Seamen on board the said Ship, viz.

[________]

[________]

[________]

Approved

Surgeon,

Captain

To Mr. [________] Agent [________] of the Naval Hospital, [________] at [________]

Received the [________] the above articles, viz,

[________]

[________]

[________]

Surgeon

N. B.- In the Receipt is to be inserted in words at length the respective articles and quantities received.

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