Case Number: 95L 00099
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Name: CURTIS, DUSTIN
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FARR CHIROPRACTIC CLINIC DUSTIN CURTIS
| Receipt Number | Receipt Date | Payor Name | Description | Total Amount |
|---|---|---|---|---|
| 23978 | 5/10/1995 | FARR CHIROPRACTIC CLINIC | DOCKET FEES | 16.50 |
| 28770 | 9/18/1995 | GOODYEAR/CUSTIN CURTIS | #8-343609/JUDG/STAMP | 0.00 |
| Receipt Number | Transaction Date | Description | Amount Due | Amount Received |
|---|---|---|---|---|
| 23978 | 5/10/1995 | PAYOR-> FARR CHIROPR | 16.50 | 16.50 |
| 28769 | 9/18/1995 | JUDGMENT AMOUNT | 66.50 | 0.00 |
| 28770 | 9/18/1995 | PAYOR-> GOODYEAR/CUS | 0.00 | 66.50 |