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NOTICE OF LIEN ~-fRK Ctt:r,Y17 ~Oa~
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STATE J:' FLQRIDA 35~~~8 ~
COUNTY OF ST. LUCIE ~
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NOTICE is hereby given that pursuant to the provisions of
Chapter 65-2181, Laws of Florida, Acts of 1965, the Board of County
Commissioners of St. Lucie County, Florida, claims a lien in the
;
amount of Two Hundred Ninety-two and no/100 ~
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292.00 ) Dollars against any real or personal property or
interest therein presently held or after acquired by
(Name of
Patricia Hoffman of 623 So. llth St., Ft. Pierce, Florida
Indigent or Recipient) (Address)
for money directly spent by St. Lucie County for the care, hospital-
ization, sustenance or~maintenance of said Indigent or Recipient ~
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of welfare assistance, as follows:
Hospital: Fort Pierce Memorial ~
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Date Admitted: Out- atient care
Date Discharged:
I Number of Days: at $ per day= $ 292.00
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3/24/76 Liver Scan $108.00 Less credits None ~
8/5/76 X-rays 70.00 €
10/12/76 Liver Scan 114.00 Amount of Lien $ 292.00
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DATED at Fort Pierce, Florida, this /~j day of
~ December , 19 76 .
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(S ' gnature) ~
~ ~ - County Attorney ~
~ (Title) ;
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!
~ SWORN to and subscribed before me .
this ~G ~ day of icr~ _ , 19~.
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Notary Public State of Flori a at I~arge~-fl~' ; ~
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~ My Commission Expires: 1 • .
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