Consultation Receipt
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Carton Podiatrist Date: September 23, 2015 Receipt 6756-098A Received From: Mr. Adam Smith carton Amount: 23,456.30 Amount in words: Twenty three thousand four hundred fifty six and 30/100 Dollars For payment of: Purpose of payment Duration of payment: From starting date To end date Paid by: Cash Check (if) Check No: ...
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