Vintage prescription, CLAY COOVER PRESCRIPTIONIST Kansas City Missouri, in n-mint+ unused new old stock condition. Nice clean form. Size is 4 1/8" x 4 7/8". Back is blank. The black border is so all the edges can be seen and is not part of the prescription 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.