Enterprise Scheduling Payments Clerk

James McNeill

PO Box ***

Southern Pines, NC ****8-0694

Enterprise Payment Receipt

Serial #: 1227713 Date: 11/14/23

Guarantor ID: 424249 Guarantor Name: James McNeill Patient Name: James McNeill Department: FirstHealth Enterprise Scheduling

Account # Appt/Admit Date Type Source Reference Payment 100********-**/21/2023 Other Credit Card 016694

Visa x4018

$1,526.29

Total Amount: $1,526.29

Enterprise Payment Receipt

Serial #: 1227713 Date: 11/14/23

Guarantor ID: 424249 Guarantor Name: James McNeill Patient Name: James McNeill Department: FirstHealth Enterprise Scheduling

Account # Appt/Admit Date Type Source Reference Payment 100********-**/21/2023 Other Credit Card 016694

Visa

x4018

$1,526.29

Total Amount: $1,526.29

MERCHANT COPY

Payment Methods

Visa x4018 $1,526.29

Authorization number: 016694

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