[PROVISIONAL TRANSLATION FROM PERSIAN]
[Translator’s notes appear in square brackets]
[Personal information has been redacted.]
Date: 21/8/1360 [12 November 1981]
The sum of two thousand rials, 2,000 rials, was received from Mr./Mrs. -----, to be handed to Mrs. Masoudeh Azizi, prisoner in section 246.
Name of the recipient of the money -------
Attention: Make sure that the receipt is not lost.
Page 2 for the recipient of the funds