Leah Gonzalez

  Central Regional Medical 
 5330 O'Donavan Blvd 
 Walker, LA, 70335-6351 
 P: (225)333-1312 
 F: (233)380-1314 
 Receipt 
 Patient
 Leah Gonzalez (Case: Arrhythmia) 
 BIRTHDATE:10/2014/25
 Date of Transaction: 05/2019/20 
 45947 Hill Passage
Josephland, PW 16297 
 (985) 614-9048 
 (990) 507-9456 
 SERVICE DATE
 Payment 
 Description 
 Amount Due 
 Amount Paid 
 Paid Method 
 Auth / Check 
 Type 
 Credit Type 
 # 
 11/2018/21 
 Office Visit 
 Copay 
 $89.00 
 89 
 Cash 
 Copay 
 Total: $89.00 
 electronically signed by Dr Leslie White, M.D., 05/2017/09 8:22 AM 
 Thank you for your business! 
 Date: 2022/02/11 
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