104-10510-10141
2025 RELEASE UNDER THE PRESIDENT JOHN F. KENNEDY ASSASSINATION RECORDS ACT OF 1992
14-00000
. :
Hospital
25th ST. HIALEAH, FLA.
TIME INSURATER.
OR FM. PENT
BATT
ADED
5-12-65
DOCTOR A CARGAS
412 1852.52
PATIENTS NAME A.
68.
•PEREZ, RIGOSERTO (CRUZ)]6
1700 N.M. 21 TERRACE 8
TRIAH, FLA.
8
P.O. DOT 1838
HIAMI, FLA.
•
TIME
f
RATE
NO DAYS
21.00
IATISINGS
....
1.00. 65
COLLENA
733314
CODE
M....
Quba
TOTAL
CITGEN
SLESIZE CHARGES
OLD E
PAYMENTS
DATE
BALANCE
:
2100
21.008300 15.25
25 26.00 + LITER SCAN
8103°
473 126
21001
0
3000+4
21.0011.05 600
9.75 30.00+20
:
21.00
21.00 600 265
# 21.00 303
21.001 3.00 3.50
say
200
1.50 +23 KIT
20200
8500
B06.00
alko 1
327.001
112.730
327.00 1
439.709
171.90
4397
16's
61125
24.000
811.25 APR 17'sb
01520
57.54•
635251
072.73
21.00
2.00 3.25
03 3.03 1925
1.02
1220
21.03
1.002 5.00 0.00
.00
300
12.00
10.00
20.00 +19
MAY 10 13.5
21.00
250
12.0.0.
21.01
21.00
10.02+
10.00+1
10.CU+14
10.00
12156
*;.).
31.031209
2411602913
10'16
TAL
8720j
67719
73600
28.00
78230
778251
4223°
778238 21'
320.501
Pay
1
5.52 RS
24.400
FINAL
DIAGNOSIS
1 OPERATIV
DISPOSITION OF CASE
WENT BE MADE TO SUBSCRIBERY
SPECIAL SERVICES
CODE EXPLANATION
པ་
6.3347
DIL: NG
COLUMN A
COLUMN B
16
ELECTROCARD OGRAN
7. PATHOLOGY
16
ELECTROENCEPHALOGRAM
•
X RAY THERAPY
13
PHYSICAL THERAPP
21
BLOOD & BLOOD PLASKA
20
TRANSFUSION SET UP
24
ORTHOPEDIC EQUIPMENT
23
EMERGENCY SERVICE
40
TEL & TEL
27 RADIO ISOTOPES
65029
CELGRYARD Wiðd¿§kentees
1 SURANCE,
* ADD DEDUCT BRE
་
DUE FROM
PATIENT
Liss
PAYMENTS
WE DO OUR BEST TO
HAVE A FINAL BILL WHEN
REQUESTED. AT TIME of
DISCHARGE THIS IS NOT
ALWAYS POSSIBLE, So
MEDICINE GIVEN AND
SERVICES PENDERED ON
DAY OF DISCHARGE
WHICH ARE NOT
CHARGED WHEN PATIENT
LLAVES THE HOSPITAL,
WILL BE BILLED LATER.
05 24°00
942000
943.00 APR 24°16
983001
25.
1977 * 26'0
01270
$77.500
4,012.201
4626.201
175
BALANCE
ουσ
VESE NO
NO{ 1
AS.:
..M SIMON, JR., M.D.
RALPH L. PIPES. M D.
RADIOLOGISTS
1222EBUSINESS, INC 3.241 no
OUR BUSINESS OFFICE
IS CLOSED FROM
SUNSET FRIDAY TO SUNSET SATURDAY.
"
L
Palle