RECEIPT HA CUSTOMER RECEIPT
IPTC***
**i
Oper: SMOCK Type: CP Drawer: 1
Date: 12/19/16 52 Receipt no: 189147
Year Number Amount
2816 58848416
91749 TECH 2
LILLINOTON, IC 27546
B4 BP - ENV HEALTH FEES
$758.89
NEW TANK
MOSS HONE BUILDERS
Tender detail
CR CHECK DAYIEN 6988 $758.88
Total tendered $758.88
Total payment $758.89
Trans date: 12/19/16 Time: 14:45:59
as THIN( YOU FOR YOUR PATIENT as