FORM NO. 95. Voucher for boarding and lodging. (Paragraphs 240 and 534.) Voucher for hospital expenses and medical aid. (Paragraphs 240 and 534.) CONSULATE OF THE UNITED STATES OF AMERICA AT Το DR. For medical aid and attendance supplied the following-named destitute American seaman admitted in and discharged from [here insert the name of the hospital] by order of ter ending 188 Consul at for the quar (Here name all articles of clothing furnished, including Voucher for burial expenses. (Paragraphs 240 and 534.) CONSULATE OF THE UNITED STATES OF AMERICA AT To DR. For burial expenses of the following-named destitute American seamen, who died at during the quarter ending November 22, November 26, Received sum of -, day ——, 18-: FORM NO. 99. UNITED STATES CONSULATE, Report of contagious diseases and deaths. (Paragraph 334.) 188-. Total deaths from all causes during the week reported, Present officially estimated population, Weekly mean of thermometer, Weekly mean of barometer, Prevailing diseases (and other pertinent information), U. S. Consul. NOTE.—This form is to be transmitted to the Department of State unac companied by a dispatch. FORM No. 101. Record of Treasury fees (seaport Consulate). (Paragraph 544.) day of On the before me, the undersigned, personally appeared United States Consul at —, and made oath that the above and foregoing account or report of fees is a full and perfect transcript of the register which he is by law required to keep; that the same is true and correct, and contains a full and accurate statement of all fees received by him as such Consular Officer, or for his use, for his official services, to the best of his knowledge, during the period of time therein mentioned. Sworn to before me. U. S. Consul. NOTE. This Form is to be transmitted to the Fifth Auditor of the Treasury at the end of each quarter. |