| Heading and notes: | Form number E.T. No. 55. Standard Imterim heading. |
| Message area: | Seven lines. |
| Reverse side: | Blank. |
| Colours (text & form): | Black on green. |
| Size of form overall: | 134 × 194 mm (top section only) |
| Size of datestamp box: | 23 × 30 mm. |
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WI-RO-1.
Ravensthorpe to Perth
|
Details of use and rarity.
| Form sub-number |
Schedule number | Earliest recorded date | Rarity rating |
| DO-1 | None on this section. | 12 February 1910 at Perth ETO. | NC |