Document B7zdn9G0Yj2JvJbdMzOqm0V8

PORTSMOUTH 7-6600 CLEARING INDUSTRIAL CLINIC 5548 WEST SIXTY-FIFTH STREET CHICAGO, ILL, 60638 Statement of your Account Dec. 31. 19 80 mZRiCM CYAiLOID CO. . 4500 15TE ST. CHICAGO. ILL. 60623 Phys. PLEASE RETURN DUPLICATE WITH REMITTANCE AMOUNT REMITTED $ . DATE DESCRIPTION CHARGES CREDITS BALANCE BALANCE BROUGHT FORWARD DEC 3*80 &5<69, "rT'6&&0' Dee...yefr- NARA- DEu 11^33-W* 133,96-4- OEC 11*80 JA^ES ANDERSON/ID. BID , 5.00 4 ERNEST CROSS H 5.004 INNEV POWERS 5.004 eijYDELL BURTON " 5.00 4 "ggOlOO DEC 12*80 FOR LEAD BLOOD S D RAWN AT YOUR CHGO P LA|NT O..N. 1_ 2/j,11/80...... 55.00 + ~6~7 j.OO *' DEC 17*80 JAS. HOOGE/ID. BL<L ODD 5.00 4 -t5Q0:GQ- DEC 23*30 SAM TATE-RTW PHYS 14.00 + WliTH/ LEAD BLOOD 5.00 + W/PA-LAT CHEST X-RAYS 28.00 + DEC 23*30 OCT PHYS ft V- IFF 1H n LG H/-SHIWT-6N/43 3.QC& 70.00 727.00 657.00 780.Ci.Q i :c 30'80^f i)R NOV.19 SPREAD b l o o d 's d r a w n b y u s An d h a il e d TO WEST LLIS-18 AT 10.Op- 180.00 -Sheeree-* it trr?r r ; . .r ni tO ! n h / ?* . s i * t ... * 'V ih 'fLj >5t>1.00 PAY LASTAMOUNT IN THIS COLUMN N9195