Old TEXAS DRUG STORE OPIUM COCA Medicine PHARMACY Form

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A great, original 1936 Treasury Department issued order form for Opium or Coca Leaves, or Compounds, Manufactures, Salts, Derivatives or Preparations! Please see photos! An earlier version of this form, from the 20s, was recently shown on the History Channel, for a program on illegal drugs...during the cocaine segment! It is ornate with a beautiful poppy graphic on the top, left corner! The order was issued to H. M. Westover, of Streetman, TX, on November 7, 1941. The form is large, 10 3/4 by 8 1/2", is watermarked , United States Bureau Internal Revenue, has some bends in the paper, 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 me, thanks! Shipping is $2.00, if you are overseas or Canada, $2.50, thank you!