118-T2x, 2018 ALA Test Design U.S. Christmas Seals Sheet, R19-CSCS-4-09, VF, MNH. Issued 2018 by the American Lung Association (ALA). Licensing by Curtis Licensing.
Images of boy and dog looking at stack of Christmas presents, men decorating large Christmas tree, Santa hugging a child, children on bobsled, red truck with Christmas trees, child reaching into Christmas stocking with wreath in background. All images trimmed in red within green border. Christmas Seals 2018 at bottom of each seal.
Sheet of 42 (6x7) seals, without gift tags, margin on all four sides. Dated 2018 with "R19-CSCS-4-09" in bottom margin.
Ten Ways to Stay Healthy on the reverse of sheet.
These are test designs. Since 1979, the American Lung Association has issued test designs to determine the design of the national seal for the following year.
Christmas Seals are also known as TB Charity Seals, and are usually classified as Charity Seals, or Cinderella Stamps.