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Date: 2021-10-02 14:47:58.671262
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Date: 2021-10-05 22:37:34.637738
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Requested from OPAPP by R. Medalla at 02:47 PM on
Oct 02, 2021.
Purpose: To pay hospital bill to continue to receive treatment
Date of Coverage: 09/25/2021 - 10/02/2021
Tracking no: #OPAPP-883666557459
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