The object was acquired by the United States Holocaust Memorial Museum in 1995.
White paper form; recto: black ink, upper left corner, logo in form of encircled Star of David with letters"G" incorporated into star; heading beneath logo reads,"GHETTO-WERKSTAETTEN/VILIJAMPOL"; upper right quadrant, title reads,"Ausgabeschein Nr."; lower section of form composed of categories and lines printed in black ink.
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Height: 8.270 inches (21.006 cm) | Width: 5.390 inches (13.691 cm)
Delivery receipt from a Kovno ghetto workshop