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This 248-page ledger book appears to be a nurse's patient record for the Helen Mae Lennon Hospital. Each entry includes the date, the patient's name, treatment instructions or progress, and a doctor's signature. Treatments are varied, but often feature castor oil, soda bicarb, soft diet, bed rest, and hot water bottles. Doctors' signatures include E. F. Lennon, M. L. Boyd, and S. M. Clark.