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Hi,

Customer/Point of Contact:

Future Smiles Orthodontics
Dr. Paul Sauget DDS, MSD (671-648-9888)

Scheduled Date/Time:

05/17/2018, 09:00 am

Service Type:

Onsite

Charge Type:

Normal

Charge Code:

FSOG.4001: Future Smiles - Network Project

Rates:

Network Project [TOTAL HOURS: 20]

Remaining Hours:

-30

Est. Service Time (hrs):

Reference/PO #:

Taken By:

Christopher Unsiog

Customer Signature:

Print Name:

Date Signed:

Invoice Number:

027013

Terminate lines in remote locations.

Work Requested by:

Work Completed :

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