James Thompson

  Mountain View Medical 
 5400 O'Donavan Blvd 
 Walker, LA, 70405-6351 
 P: (225)340-1312 
 F: (240)380-1314 
 Receipt 
 Patient Name
 James Thompson (Case: Congestive Heart Failure) 
 birthdate:23/01/2024
 Date of Transaction: 02/10/2014 
 3858 Michelle Flats Apt. 572
West Michael, SC 26290 
 (985) 614-2048 
 (920) 507-9456 
 date of service
 Payment 
 Description 
 Amount Due 
 Amount Paid 
 Paid Method 
 Auth / Check 
 Type 
 Credit Type 
 # 
 25/10/2017 
 Office Visit 
 Copay 
 $48.00 
 48 
 Cash 
 Copay 
 Total: $48.00 
 Signature Dr Terry Moran, M.D., 10/09/2018 8:22 AM 
 Thank you for your business! 
 Date: 2021/12/03 
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