Product	Price	Qty
COPY FOR YOUR INFORMATION PTR 40	$14.50	1
PATIENTS SIGNATURE ON FILE PTR 40 RED	$14.50	1
NO MAIL RECEPTACLE PTR 40 RED	$14.50	1
ORIGINAL PTR 40 RED	$14.50	1
PHYSICAL DUE PTR 40 RED	$11.90	1
5 items in cartTotal:	$69.90

Product	Price	Qty
COPY FOR YOUR INFORMATION PTR 40	$14.50	1
PATIENTS SIGNATURE ON FILE PTR 40 RED	$14.50	1
NO MAIL RECEPTACLE PTR 40 RED	$14.50	1
ORIGINAL PTR 40 RED	$14.50	1
PHYSICAL DUE PTR 40 RED	$11.90	1
5 items in cartTotal:	$69.90