| | Walter | Disney | PatientID: | 35245 |
| | 6544 Second Ave |
| | Florence, MA 05884 |
| | 4/12/2010 | | Glucose | $395.00 |
| | 4/12/2010 | | AST Test | $550.00 |
| | 4/12/2010 | | Red Blood Count | $55.00 |
| | 4/13/2010 | | Strep | $80.00 |
| | Total Due: | $1,080.00 |
| | Please mail payment to: |
| | Labs 2U |
| | PO Box 45 |
| | Atlanta, GA |