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SAN j AQUilei LOCAL HEALTH IJP c=i RTC.'f , <br /> 1601 E, Haze trio Ave. , F' Box '2'0Q':-1 <br /> (20119) 468-3-W-5 <br /> .og—I Khanna, MAD. , Health Officer <br /> US'R Ni4 <br /> U.S.. RENTFAL:= �:�. R NiAL' <br /> 1 x-44 E RD J444 E R <br /> 3i d i i3`i' =.tateffient. Fc,r, �'ki ;'i ; itll i•, Lir-Ide-pr'g1'Csumu I ank Fc-.0 l i it•'r . <br /> Date Ja"nuar-Y I 1190F) <br /> Payment- Due <br /> Fc4C;',1 it v }[)f) ()i) <br /> Feel <br /> t1c,'slt ai nier Nu.fib 1'• i 000i i ;i."} C)[) <br /> o003}': ids(;).1'.10" <br /> .s k' i f i SCS <br /> Heziith D i9ti; ict. of =xray <br /> CfD1"pec t-]CsDS CZY' Ci3t F'}ems <br /> ni c s5ary . `i'fjur pr--rm t ilIt <br /> be t'iici3.leu i.a�,[s�l -fl e=eiF't. itt' <br /> t°c'i-iffient. alms rr�'i +vii <br /> If,ir_iIity . <br /> REt'urii F=cl)`i{it'ifC• along, i ri oie <br /> c'Al--4 ")aiFi(NIN U .AL. HEA i L+l; I4�1L-I <br /> i= �Jlr,ilj}IP'l i�lri� HEALTH <br /> STOCKTON., CA 'X32" <br /> Pe <br /> due date as shown 1 <br /> `tiL) days - i-}i,_i% Cif Base I"ee <br />