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Show Muzzle Measles Registration Form SATURDAY, MAY 13, 1967 PARENT OR GUARDIAN STREET ADDRESS TELEPHONE NO - CITY OR TOWN-..- I NAMES OF CHILDREN TO BE IMMUNIZED AGE I I hereby state I am the PARENT OR GUARDIAN and hereby request that measles vaccine be administered to above listed minors. Signature Parent or Guardian BE SURE TO BRING THIS FORM WITH YOU! r x s 'fvJ -- , , , pin-fyf v... j , - - J fetP V ' ! fv: tli. fi 1 v x t : - lo v s"s-v? ( ! "I want Full Service with my Checking Account!" When you have a checking account here you have more than the convenience, prestige, and safety of being able to pay by check ... in person or by mail. More than easy-to-file cancelled checks as receipts. You have all of the best modern banking services right here, too . . . conveniently under the same roof! That's "Full Service" banking for you try it, here and now! MILFORD STATE BANK A FRIENDLY BANK FOR ALL THE PEOPLE All Accounts Insured Up to $15,000.00 by the Federal Deposit Insurance Corporation j |