The papers contain accounts, a commission, two letters, a lien, and receipts, statements of account and tax receipts. Most of the accounts, receipts and statements related to Pickens' medical practice, including accounts for his services to the G. W. Miller family; a running account with James Hunter's Sons (Hunter's Store) in Pendleton, SC, where groceries and general merchandise that were exchanged for medical services, as well as several accounts with James Hunter; and an undated letter from [E. E.?] Miller describing the symptoms of one of his patients. This material represents his interactions with over a dozen families and business transactions with more than twenty businesses and merchants in Anderson, Charleston, and Pendleton. The commission, dated August 2, 1880, appoints Pickens as the medical examiner for the Pendleton lodge of the Knights of Honor. There is also a May 22, 1882 notarized statement given by Pickens to P. H. Sloan stating his birth date, place of birth and medical qualifications.