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58117*** RECEIPT*** Date: 07/18/13 Receipt: 58117 Quantity Transactions Reference Subtotal 1 Op And Assy (1203) 13-4893 $200.00 Total Paid: $200.00 Notes: Payment Type Amount CK #285407 $200.00 Name: Laerdal Medical Corporation Po Box 38 Gatesville, TX 76528 Paid By Laerdal Medical Corporation Clerk ID: JF Internal ID: 13-4893