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c''SENDER: If , <br />/tYum <br />®Complete items 1 and/or 2 for additional' <br />I also sh to twelve the <br />®Complete items 3, 4a, 4b. <br />following services (foran <br />■ print your n address on the reverse of this so that wehis extra fee). <br />card to you. <br />®Attach <br />this form to the front of the mailpiece, or on <br />the back if space does not 1. 0 Addressee's Address <br />perrrd <br />tRetum <br />® <br />■write Receipt Req ed' on the mallplece below the article number. 2. 13 Restricted Delivery <br />■The Return Receipt will show to whom the article was delivered and the date <br />delivered. <br />Consult postrnaster for fee. <br />3. Article Addressed to: <br />4a. Article Nufter <br />�. <br />'c' <br />SAN JOAQUIN CO HEALTH <br />CARE <br />ATTN: ACCTS PAYABLE <br />Service Type <br />[3Registe <br />1 <br />PO BOX 1020 <br />rtified <br />STOCKTON CA 95201 <br />❑ Express Mail 0 I redw <br />3 <br />Return Receipt for Merdtandise E3 COD <br />7. Date of Delivery <br />OR 15 1 <br />5. Received By: (Print Name) <br />S. Addressee's Address (Only if requ ted <br />Y <br />and fee is al) <br />a <br />6. Signatur rAgent) <br />a <br />' <br />PS Form 3811, ecem 1 84 <br />102595-97-13-0179 Domestic Retum Receipt <br />