This vintage chemical analysis form includes lines to record the name of the sample, where it was obtained and who it was manufactured by. There are lines to record a variety of science experiment results as well as a space for remarks, lines for the signature of the person recording the test results and for the date to be entered. 
I scanned the original page from Elementary Applied Chemistry by Lewis B. Allyn. The book was published in 1912.
Julie is a vintage enthusiast and a Photoshop addict who collects old books and new recipes.
Contact her at: theolddesignshop(at) gmail(dot)com
Thank You for sharing all of your vintage designs.
You’re welcome Nikki. 🙂
Hi there, these are all so nice of you to share. I have tons of vintage magazines and books. Can you tell me about how you created copies of them for people to download? Perhaps I can share as well 🙂