n. JAMES J. SIHARPE, M. D. 2612 TEXAS N. E ALGUQUERQUE, NEW MEXICO 871 10 Teveryore 299.1021 PRIVACYACT MATERIAL REMOVED DATth2S. : : PATIENT'S NAME 7" am 7" ‘ “ADORESS __ SERVICES RENDERED FEE AC. CONSULTATION Lh X-RAY , Ke INJECTION SURGERY 4 Alo (Fy ce ial iP if ONE DIATHERMY YU! Le LABORATORY ATae q Gulf ERGs . LhroahSZ TOTAL Ss S ee 3/ NEAT APPOINTMENT PLEASE LEAVE WITH RECEPTIONIST pRIVACY ACT MATER| AL REMOVED ’