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File:Prohibition prescription front.jpg

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This work is in the public domain in the United States because it is a work prepared by an officer or employee of the United States Government as part of that person’s official duties under the terms of Title 17, Chapter 1, Section 105 of the US Code. Note: This only applies to original works of the Federal Government and not to the work of any individual U.S. state, territory, commonwealth, county, municipality, or any other subdivision. This template also does not apply to postage stamp designs published by the United States Postal Service since 1978. (See § 313.6(C)(1) of Compendium of U.S. Copyright Office Practices). It also does not apply to certain US coins; see The US Mint Terms of Use.
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This is an official government document from the 1920s, a Medicinal Alcohol form. This form was used during the American Prohibition to acquire prescription alcohol, usually whiskey, for strictly medicinal purposes.

Taken from The Authentic History Center (seen in context here).

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applies to jurisdiction: United States of America
determination method or standard: work of the federal government of the United States

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current01:44, 1 May 2005Thumbnail for version as of 01:44, 1 May 20051,276 × 676 (127 KB)Master Thief Garrett~commonswiki{{PD-USGov}} This is an official government document from the 1920s, a Medicinal Alcohol form. This form was used during the American en:Prohibition to acquire prescription alcohol, usually whiskey, for strictly medicinal purposes. This image came fr

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Quelle: https://en.wikipedia.org/wiki/File:Prohibition_prescription_front.jpg