i <br />L ljt~•~ i C?._~ <br />~wrt w wvanww n. <br />995 WILLAGILLESPIE RD <br />v. <br />n100 <br />PILAR A. BRADSHAW M.D. <br />EUGENE OR 97401 <br />j 995 WILLAGILLESPIE RD IUUD <br />541-484-5437 <br />I EUGENE OR 97401 <br />Merchant ID: 79N9592 <br />541-484-5437 <br />.ri .n ID: 0002 <br />! Merchant 10: 7009592 <br />Term TD: 6002 <br />Sale <br />I <br />_ <br />J <br />MC-PURCH <br />MXX <br />XXXXXXXXM5557 <br />MC-PURCH <br />Entry Method; Swiped <br />XMXXXXXXMXXX5557 <br />paarvd; Online Batchq; <br />ppppp5 <br />Entry Method: Manual <br />06i16i10 <br />1 <br />4:17;43 <br />Apvrvd; 0ffline Batchq; 000007 <br />0618/10 16:20;37 <br />In-& 00000009 Aanr Code: <br />020620 <br />10: 00000003 Avar Code; <br />Amount: $ <br />15 <br />00 <br />Ta <br />: $ <br />. <br />Amount: S 15.00 <br />x <br />0 <br />00 <br />. <br />Tax: S 0.00 <br />Total; S <br />15 <br />0u <br /> <br />= <br />. <br />8 <br />Total; <br />15.00 <br />Cos Lom rr CJav <br />Customer Covv <br />I nM+H YOU <br />FD" y, <br />THANK YOU <br />FOR VISITING! <br />