This wonderful drawing of a horse reminds me so much of Native American ledger drawings (which are some of my favorite things in the world), all the more so for being done on a lined examination booklet. I assume Samuel Joseph was a student when he did it, but don't know for sure. Definitely it is quite old, and I find it to be a pretty perfect thing. There is a second similar horse drawing (actually two drawings, as it is double sided) listed separately. 

9 x 11 7/8". Overall good condition, with some smudges and stains on both front and back and an old fold down the middle.