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[pre-printed check form]
Exchange for California $790.00 Banking House
Of Donohoe, Ralston & Co. San Francisco Octo. 31st 1862
Pay this DUPLICATE of Exchange (original unpaid) to the order of J. E. Auger Seven Hundred Ninety one 00/100 dollars Value received and place to account of
to Mess. Eugene Kelly & Co. New York City [signature] D. M. Wood Ralston ? No. 3849