HomeMy WebLinkAbout0273 z3~,gs .
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ICNOI~f ALL M~N BY TIiCSr PRESrN'PS:
Tllut GOOD SAM:IRI`PAN HOSPITAL ASSOCIATIOPI, OPTRATING TIi~ GOOD
SAI~IARITAN HOSPITAL, tiaes t Palm Beach, rlorida, tho owner und holdor of
a cartain Lion for tho il~rnishin~ of has~ital services to Z~Xl~ L.
CuwDAY , as a patient in said hospital, has
rQCeived i~zll pa~ent of the sums to w~iich it became entitled by
virtue thereot, and tor and in consideration of the sum of ?$RE'S
'~uSA~ !m: ?EII~li E~E'! DOLL~RS AID ~p~ CI~?~ DOLLARS,
~ •
does hereb~ aclanowled~e full payment and complete satisfaction of said
Lien, notice of which was duly executed and recorded in the public
records of Palm Beach County, Florida, on the 13th day oi'
, 19~a in Official Record Book 203 , page
81~_, and the said Good Samaritan Hospital Association,
Operatin~ the Good Samaritan Hospital, does hereby itiilly release and
discharge the aforesaid patient from the operation and effect of said _
~ Lien Claim, and the Clerk of the Circuit Court of Palm Beach County,
Florida, is hereby directed to satisfy and cancel said Lien.
I IN WITIirSS ZJ~iT.~tEOF, the said GOOD SAt4ARITAN HOSPIT~'1L ASSOCIA-
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~ TIOI1, OPr~ATING TH~ GOOD St~MARITAN HOSPITAL, ~•Jest Palm Beach, Florida,
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~ has c3used these present~ to be signed in its name by its Billin~
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~ Supervisor and witnessed by the undersigned. •
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- GOOD S11t~RITAN HOSPITAL ASSOCIATIQN
OPERA~i~E GOOD SAI~iARITAN SPITAL
By ~ - _ t
(Mrs. Pearl H. Long
Billing Supervisor ,
~ 1litncss : ~ -
~ - ~ ~ ~
~ • e~ ~ =+e fILEO AN4 aECOR0E0
St.IUCIE C4t1MTY FlA•
Billing Clerk ROCEs~ P~~jRAS
~ CLERK C~~~ ~~T ~OURT ,
Subscribed ~nd sworn to RfCORa YE-•~=+~~~ _
~ be foro me thi s 23 Da;~ 5 4 03 PM ~7Z #
of p~at 1972 '
~ - s. 23'7464 ~
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~ Notury lic ~ ~ .
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NOTARf rIIeUC. STIRE Of ROR(DA AT LJIRCE .;C, ~
MY COMMISSION EXPIRES MAR. 5, ]g7t
BONDEO iHRU FRED W. DIESTfl!lORST ~,1~ ~ C.,.~
r;~ : , C R ~U ~7~
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