Jacob Shaw

 
 PROGRESSIVE IMAGING MEDICAL ASSOCIATES 
 PO BOX 571137 
 MODESTO, CA 91157 
 (211) 111-4110 
 FAX (211) 411-4116 
 RADIOLOGY DEPARTMENT FILM BREAKDOWN 
 Equi Copy 
 625 The City Drive South #110 
 Orange, CA 91168 
 Medical Records on the following: 
 Patient Name: Edward Foster 
 Order Number: 111211-30 
 Medical Record Number: P112117 
 Service Date 
 Exam 
 2015/08/07 
 Xray Ankle 
 CD COST $80.00 
 Please call to order CD. 
 Thank you, 
 9117 
 Aileen Griffin 
 0003
