| Heading and notes: | Form number may be 68 (TRC). Heading is LAUNCESTON AND WESTERN RAILWAY TELEGRAPH. | 
| Message area: | Blank. | 
| Reverse side: | Blank. | 
| Colours (text & form): | Black on blue. | 
| Size of form overall: | 226 × 213 mm. | 
|  Printed July 1873. | TC-DR-1. Westbury to Launceston Provenance: Gundersen. | 
Details of use and rarity.
| Form sub-number | Schedule number | Earliest recorded date | Rarity rating | 
| DR-1 | 2000 | 7 | 73 | 25 November 1873 at Launceston. | RR |