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FOHN As-Kev. 4-ma.
Order from The
Doo Tozme
=
are
3.
Board No. T 16002
Insurance Co. No.
W 11672
Juna 10,
, 1959
INDUSTRIAL ACCIDENT BOARD
Austin, Texas
You are hereby notified that payment of compensation has been suspended or stopped in the
above numbered and styled claim, and that the date of the issuance of the last draft or other
evidence of payment is the 19th
day of
Jstuld
May
, 19...99
which paid compensation from
May 14,
, , to 20th day
of
May
19. .99
Incl.
The reason payment has been suspended or stopped is as follows:
Claimant's physician reports that she is able to work.
RECEUVED
'***:
1:1050
TEXAS INDUSTHIAL
ACCIDENT COARD
Total amount compensation paid $ 583.80
-
Weekly rate paid $ 29.69
Compensation paid from 12-6-58 to 12-8-58, td 12-11-58 to 12-12-58, comprising
12-27-58 to 12-29-58, 1-3-59 to 1-18-59, 1-21-59,26 1-24-59 to 2-2-59, 2-3-59 to 2-16-59,
20
weeks
days.
2-19-59 to 5-20-59 Incl.
Liberty Ins. Co. of Texas,
Name of Insurance Company
Box 939, Fort Worth, Texas
Address
Marguerite C. Oswald
313 Templeton, Ft. Worth
12-5-58
"Name of ('laimant or Benefleiary
Addrews
Date of Injury
King Candy Company
813 East Ninth, Ft. Worth, Toxas
*Subseriber
Address
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"ocrText": "FOHN As-Kev. 4-ma.\nOrder from The\nDoo Tozme\n=\nare\n3.\nBoard No. T 16002\nInsurance Co. No.\nW 11672\nJuna 10,\n, 1959\nINDUSTRIAL ACCIDENT BOARD\nAustin, Texas\nYou are hereby notified that payment of compensation has been suspended or stopped in the\nabove numbered and styled claim, and that the date of the issuance of the last draft or other\nevidence of payment is the 19th\nday of\nJstuld\nMay\n, 19...99\nwhich paid compensation from\nMay 14,\n, , to 20th day\nof\nMay\n19. .99\nIncl.\nThe reason payment has been suspended or stopped is as follows:\nClaimant's physician reports that she is able to work.\nRECEUVED\n'***:\n1:1050\nTEXAS INDUSTHIAL\nACCIDENT COARD\nTotal amount compensation paid $ 583.80\n-\nWeekly rate paid $ 29.69\nCompensation paid from 12-6-58 to 12-8-58, td 12-11-58 to 12-12-58, comprising\n12-27-58 to 12-29-58, 1-3-59 to 1-18-59, 1-21-59,26 1-24-59 to 2-2-59, 2-3-59 to 2-16-59,\n20\nweeks\ndays.\n2-19-59 to 5-20-59 Incl.\nLiberty Ins. Co. of Texas,\nName of Insurance Company\nBox 939, Fort Worth, Texas\nAddress\nMarguerite C. Oswald\n313 Templeton, Ft. Worth\n12-5-58\n\"Name of ('laimant or Benefleiary\nAddrews\nDate of Injury\nKing Candy Company\n813 East Ninth, Ft. Worth, Toxas\n*Subseriber\nAddress"
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