| 07/18/2012 |
| 08:05:01 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| GALINDO, THERES, | A3-MEDICAL394 | R | 225.00 | 4266********3537 | 08530B | 07/18/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 0 | MasterCard | 0.00 |
| 1 | Visa | 225.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 225.00 |