Here is a first stab at it... perhaps others can add detail.
The Confederate States
To Mrs. M.A. (?) Dr.
Date of Purchase 1864 May14th
For ___ at one thousand dollars
I certify on (?) honor that the above
___ (?) is c___ (?) that I purchased
the articles above enumerated of the
Said Mr. M.A. T___y at the
price therein charged, amounting to
One Thousand dollars + that I
have not found the account for want
of Funds.
A. L. Landis Majr
G M C f A
