[PROVISIONAL TRANSLATION FROM PERSIAN]
[Translator’s notes appear in square brackets]
[Personal information has been redacted.]
Date: 17 Esfand 1360 [8 March 1982]
Amount: 3000/ rials for delivery to Mr. Abdol-Shoghi Tebyani, prisoner of ward 325, received by Mr. / Mrs. Spouse
Name of the Recipient of the Fund: -----
Note: Be careful not to lose the receipt.