Vintage prescription form, HARMON'S DRUG STORE The Rexall Store Maringouin LA., for a free ice cream cone, in n-mint+ unused new old stock condition. Nice clean form. Size is 4 3/16" x 5 3/8". Back is blank. The black border is so all the edges can be seen and is not part of the form itself. NOTE: All of the receipts I have listed are guaranteed to be 100% authentic originals. They are all clean, unused and new old stock unless otherwise noted. Thank you for your purchase, I appreciate it.