U.M. FDSP, Associates P.A.
666 West Baltimore Street
Baltimore, Maryland 21201-1586

 

Central Corporate Services
Dental School
(410)706-5095
Room G-G-10

MEMORANDUM

 
TO:   Wayne Allen
Associate Director
Financial Services
FROM:     KerryAnn Jones, Accounting Clerk
Kathy Mardaga, Executive Director
U.M. FDSP, Associates
DATE: 

SUBJECT:        Patient Refunds

Please draft a patient refund check from the Campus working fund based upon the following information:

 

Guarantor's Name:  John Doe

$    100.00     Charge account #02-3-90471 Student Clinic Revenue Expense

$                    Charge account #02-3-90813 Student Clinic Patient Deposit

Total Refund Amount: $100.00

Attached, please find copies of the patient's account documentation supporting this request.

The sub code for both accounts is 0621.

Thank you.

KM/knj
Enclosure
Cc: File