Public Health Resources for Idaho North Central District

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Clinic Payment

About this payment

Payment for clinic fees


Account Number: *
Birth Date: *
mm/dd/yyyy : Birthday of person that received treatment
Office of Service: *
Enter Location: Grangeville, Kamiah, Lewiston, Moscow, Orofino
Patient Name: *
Full name of person that received treatment
Payment Amount: *
Enter the amount to pay today
$

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