| 09/05/2012 |
| 05:54:39 |
| Name | Member No. | Cycle | Amount | CC No. | Authorization | Auth. Date |
| WILSON, MICHELL, | A3-MED-179 | R | 145.00 | 5142********6425 | 252154 | 09/05/12 |
| Count | Card Type | Total |
| 0 | American Express | 0.00 |
| 1 | MasterCard | 145.00 |
| 0 | Visa | 0.00 |
| 0 | Discover | 0.00 |
| 0 | Other | 0.00 |
| 145.00 |