Michael Walton

  Oak Grove Hospital 
 5760 O'Donavan Blvd 
 Walker, LA, 70765-6351 
 P: (225)376-1312 
 F: (276)380-1314 
 Receipt 
 Patient
 Michael Walton (Case: HIV/AIDS) 
 birth date:09/06/2019
 Date of Transaction: 03/11/2022 
 633 Miller Forges Suite 503
Pamelaland, AL 12960 
 (985) 614-4248 
 (942) 507-9456 
 date of service
 Payment 
 Description 
 Amount Due 
 Amount Paid 
 Paid Method 
 Auth / Check 
 Type 
 Credit Type 
 # 
 02/03/2018 
 Office Visit 
 Copay 
 $26.00 
 26 
 Cash 
 Copay 
 Total: $26.00 
 Electronically Signed by Dr Barbara Dudley, M.D., 01/03/2016 8:22 AM 
 Thank you for your business! 
 Date: 2014/12/13 
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