Case Number: 96L 00049
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Name: PICKETT, JANE S.
Address:
INTERNAL MED/SURGERY CENT JANE S. PICKETT
| Receipt Number | Receipt Date | Payor Name | Description | Total Amount |
|---|---|---|---|---|
| 29098 | 04/19/1996 | KS. COUNSELORS INC #49187 | INTERNAL MED/PICKETT | 36.50 |
| 32677 | 07/31/1996 | PICKETT,J/USD #383 | GARN #1/JUDGMENT | 373.13 |
| 3306 | 07/31/1996 | WILLIS & HOLMES | DISBURSEMENT | 373.13 |
| Receipt Number | Transaction Date | Description | Amount Due | Amount Received |
|---|---|---|---|---|
| 29098 | 04/19/1996 | PAYOR-> KS. COUNSELO | 36.50 | 36.50 |
| 32676 | 07/31/1996 | GARN #1/JUDGMENT | 373.13 | 0.00 |
| 32677 | 07/31/1996 | PAYOR-> PICKETT,J/US | 0.00 | 373.13 |