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SENDER-. CO[viPLETE THIS SECTION COA,PLETE THIS SECTION ON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Sig re <br /> item.4 if ry' ❑Agent <br /> ■ Print your a re h reverse LGA L ❑Addressee <br /> so that w t e B. Received by(Printed Name) C. Date of Deliv ry <br /> ■ Attach this to t e ack of the mailpiece, f�r <br /> or on the front if space permits. d <br /> D. Is delivery address different, item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑No <br /> LODI MEMORIAL HOSPITAL <br /> 975 S FAIRMONT AVE s. Service Type <br /> LODI CA 94240 Certified Mail ❑Express Mail <br /> ❑Registered ❑Return Receipt for Merchandise <br /> ❑Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7004 2510 0023 3789 2003 <br /> (transfer from service <br /> PS Form 3811,February 2004 Domestic Return Receipt 102595-02-M-1540 <br />