Antique Ornate 1920s USIR Opium Medicine Pharmacy Form

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A great, original 1923 Treasury Department issued order form for Opium or Coca Leaves, or Compounds, Manufactures, Salts, Derivatives or Preparations! The order called for 2 1oz packages of Codeine Sulphate, and 1 500 package of 1/4 Grain Morphine Sulphate Hypodermic Tablets. This particular form from the 1920s, was recently shown on the History Channel for a program on illegal drugs...during the cocaine segment! It is the only form issued with approximately 25 paragraphs of instructions printed on the back...one of which is: Narcotics lost in Transit! It is ornate with a beautiful poppy graphic on the top, left corner! Please see photos. The order was placed by Pharmacist, E. S. Fernsler, of Pottsville PA, on September 31, 1927. T his duplicate copy was kept by Pharmacist Fernsler, for his records, the top copy was sent to Smith, Kline & French, in Philadelphia, PA. The order form is large, 10 3/4 by 8 1/2", is watermarked , USIR, the drug company's name was changed, otherwise, condition is excellent! This is a fantastic piece of history and would be great to display in a pharmacy or office! I am happy to answer any questions you may have, please feel free to email, thanks! Pleased to combine shipping with other items...s hipping is $2.00, if you are overseas or Canada, $2.50, thank you!

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