I assume "G.S" stands for gun shot.
I respectfully apply to be furnished with an order on Wells Bro. Charlottesville Va., or whatever manufacturer may be designated, for an artificial limb. When a Capt. in Co. H. 9th Va. Cav. Regiment, on the 4th day of July 1864, at (Battle Field or Hospital.) Winder Hos.. My leg was amputated by surgeon Dudley* at (Seat of operation) Middle 3. on account of (Wound, accident or disease) G.S. receive in the service of the confederate States at (Battle Field, &c) Nance's Shop on the 24 day of June 1864.
My place of residence is New Kent Co., State of Va. and present address, In person
(signature) James Pollard
OFFICERS, SOLDIERS AND SAILORS desiring relief from the Association for the Relief of Maimed Soldiers, will fill up this form, make oath to the truth of it before a Justice of the Peace, Notary Public, or commissioned Officer, and forward to the corresponding Secretary at Richmond. An order will be returned for the desired limb, which will be manufactured as soon as possible.
* John Gibson Dudley. More on Dr. Dudley.
More on A.R.M.S. tomorrow. . .