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HomeMy WebLinkAbout98-00777 t' ... \l .v .. ;) 'l. " '"? "" ...... . ..... ,~ i ~ , " "to , "" ~ ..... ~ ,'.,~ ~ II! . ~ - i. ~ ~ / t ... ~ ..... . .. .;:) ~ \J ~I ~ , c... ~ ~ I' InI,i'!fIII^ T^nl.'i'llllISI'rr ^I.IM ){'\III\O,('( 1M IIInt.t Ihmtil hllflluY".I'NlI \6HlIl"" CARLISLE IIOSI'ITAL AND ImAL TlI SERVICES, Plaintil1' IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v, CIVIL ACTION - LAW NO, 98. 7 71 CIVIL TERM R, LYNN KLING, JR" Defendant JURY TRIAL DEMANDED NOTICE You have been sued in court, If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the court your defenses or objections to the claims set forth against you, You are warned that if you fail to do so, the case may proceed "';thout you and a judgment may be entered against you by the court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiffs, You may lose money or property or other rights important to you, YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE, IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU CAN GET LEGAL HELP: Cumberland County Bar Association 2 Liberty Avenue Carlisle, Pennsylvania 17013 Telephone (717) 249-3166 MARTSON, DEARDORFF, WILLIAMS & OTTO By / G rge B, Faller, Jr" Es Ir Ten East High Street Carlisle, P A 17013 (717) 243-3341 Attorneys for Plaintiff Date: February 9, 1998 CARLISLE HOSPITAL AND HEALTH SERVICES, PlaintilT v, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO, 98- 77, CIVIL TERM I ' .~ j t: \ R.L YNN KLING, JR" Defendant JURY TRIAL DEMANDED COMPLAINT , .1 AND NOW, comes the PlaintilT, Carlisle Hospital and Health Services, by and through its attorneys, Martson, DeardorlT, Willinms & Otto, and hereby avers as follows: I. PlaintilT is Carlisle Hospital and Health Services, a Pennsylvnnia non-profit corporation with its principle place of business at 246 Parker Street, Carlisle, Cumberlnnd County, Pennsylvnnia 17013. 2, Defendnnt R. Lynn Kling, Jr. is nn adult individual residing at Rural Routc #2, Box 360, Loysville, Pennsylvania 17047. 3, On or about October 21, 1993 through July 25, 1997 Defendant was provided with reasonable nnd necessary medical care by the Plaintiff nnd the Plaintiffs agents. servnnts nnd employees, 4, The outstnnding balnnce of$12,053,82 represents the reasonable nnd necessary value of the services provided to the Defendnnt and which Defendnnt has yet to pay. (A copy of the printout summary is attached hereto as Exhibit "An). 5, Despite repeated demnnd for payment, Defendant has failed to pay for the services provided, .. , I, -l ,J ) 'I . I . I J COUNT I BREACH OF CONTRACT FOR PROVIDING NECESSARY CARE 6. Plaintiff hereby incorporates by reference the avennents contained in paragraphs I through 5 of this Complaint. 7. Defendant has breached nn expressed or implied agreement to pay the reasonable value of the services rendered. .\ 'I I ( ) ~ \~ " . , II ~ i " " , , \, , I I Ii ", I' I: ~ I. if,""" : I'" Exhibit A ii PB.3.12 CARLISLE HOSPITAL 11/19/1997 PATIENT MANAGEMENT Patient Pat # ST Soc Sec Num Dis Dt T FC R Amount Due KLING JR, R. LYNN 3376290 AR 184-36-6632 07/17/97 2 60 47.00 KLING JR, R. LYNN 6993794 BD 184-36-6632 10/21/93 2 60 116.70 KLING JR, R. LYNN 8012965 BD 184-36-6632 08/09/94 2 65 51. 00 KLING JR, R. LYNN 8971848 BD 184-36-6632 05/08/95 1 60 3,643.12 KLING JR, R.LYNN 3376324 AR 184-36-6632 07/21/97 1 60 8,156.00 KLING JR, R.LYNN 3409893 AR 184-36-6632 07/25/97 2 60 40.00 ** End of List ** -trf~ /'?,16"J.8''J- Pat # Patient Name Press ENTER to Restart, or XX to Exit. EXHIBIT "A" . .... .~. . . ,. . a l ,... I~ !. .,.,., , II'" ;~;,:,~,', ,.;~ V .; IIU 1 ,. '. '0. 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TYPL = I ( ([I G rt1 S T 'r <: e>nl;: ASENT ~Y71:;4-;1 II L Y,~:J Jr<. )(L I.;(i 1 ~O 4 17 . !I S 10 .:! 19 5 E026 ! <E:;rv,"':;I~LE ~"\r\TY 1~IFOf;,,/.TION : h LYNN JR. ~LIN~ f,u, ,iOX 360 LOY.iV ILLE, PA C71'fl 7,:)9-3575 f:,\IIEIH INFi)~~"I~T Hi'~: AIm FC 'JO sri' 'I ".(e" ':I\~ ST H 511~ H4-3/J-06.52 lilS 5T 02 CNTY 1~4 ACCT kEP nlN' 104257 nRN lYO.i! "uFFHA~. hILLIA~ 5 Hn DOi! 02/2011,6 ('r.!: 1005-A DAYS 0002 ^t)~: OT 0 51l\6/9~ L5T ST~1T DT 02119/96 !7fJ47 (I:>::.;: CHARGES "ct,r",; 'O~T ING CHARGE SERVICE lATE CODE DATE TECHNICAL Di:SC'l1 PTI tj~; AHO;JNT FIN AL "ILL Ao''lOU NT 3643.12 15/06/95 PhO 60075 05106195 OIEST POiHA!1LE IV 136.40 l5106/95 P11~ 70001 05/li6/95 EKG 70.50 l5/0 0195 PHO 26740 05/06/95 CLA SS IV VISIT EM"Rr,E~!(V ~E PT. 350. 00 15/00/95 RoO 19500 05106/95 HOI)M-IJEOITCU 775.00 )51(J7/95 PHO 70:)01 05/07/95 EKe. 70. 50 l5/07/95 PHO 7il113 05/07/95 IV PUMP J;>;FU:;ION SI: RV I (F. lTE'" 16.00 15/07195 PHO ]%05 05/07/95 NON INVASIVE 5D MOt> I TO I: II,;.; 11.50 l5/07/95 PHO 191)1 5 05/07/95 CONTINUOus [1;(; /-fuN I TOP I I'!l: 11. SO l5/u7l'J5 RilO 19500 05/07/95 ROUH-'lEDIlCU 775.00 15/0eU5 PIO Hi:.P55 05/06/'15 Hl"P AIi I I'; WJECTION 500'LITS 3.60 )5".;./<;5 PIC f!cPc 0 OS/06/'i5 hEi>ABlr-.: I 'IF USI ()t, 19. 50 15/0",1',15 PIO H~P5 5 OS/06/95 HEi'AfdN I NJECT I (I,; 5000UTS 3.60 15/0<'/75 PH H EP:; 5 05/06/95 HePARIN I'UECTION 500,lLlTS 3.60 l5/06/'i5 PIO ANT2 ( 05/06/95 ALtJM/i1/,G:IESIA 5U5PENSI:H! J GML 1.75 )5/0b/95 Pl~ HED60 05/06/95 Ii!;? Afd N INFUSION 19.50 l5/0bl9S F'l! HEP55 (\5/07/05 hF.P AR!/o' I'/JECTION ; OO(lIJTS 3.60 15/0 bl ~5 Pll HEP60 05/07/QS HEPARIN lfo!FUSI0N 19. 50 )S/Oan5 Pl1 hED55 05l~7/95 H':PA"IN I'IJ:CT I 01, :OOI1;TS 3.60 ISle d/95 PIl Ii"Pc 0 05/01'195 I1EFAi~IN I:JFUSIOf,' 19.50 15/U,,1 ~5 elO ASAO 1 05/06/"5 ASP J ri II. E. (. r ,..PL,:T .. c S "i:; 0.00 IS/Db/95 (I J V.:.[(O 3 05/06/9;' Vr;,Ai'~nIL SUST .FlEL. T' - 24 (' I~:: 3.60 " - !5/0 a/')5 CIO GLl C' 2 rS/06/9S (ill PI7.1 Dc TA~Lt:T j 'j ''''= 3.60 IS/OodS Clt) Llsa :: 05/06n~ LJ"WOPRIL Ilf i, TiirL ? C. I.;.; 3.60 15/0 il/'i~ CIa P.A~l; 1 05/D6!?; RAillTII) 11'1" TAl:Lrr I c:.....,.; 7.85 ... ..v .... 15/0 ~/"5 (I ;j /I.SAC 1 OS/o6/9~ to :,p ll~ r:. ::..c. T A~,L~ 1 3~5:'~:\ 0.00 15/U1:/95 CIa VE.i,'O 3 05/06/');; V[hAP~r: IL SIJ"T .REL. Tt:. :.! I, C ~~~; 3.60 i5/03l95 CIf, GLlu 2 OS/06/ryS tiLl PIll Dr, TAtlL:.T 1.0 "!-i 7.20 IS/~~/,~ (11 TEr,U 3 C5/06/95 n-;., Al '};j!;-I /"YT" Ii; T,..,'~ i.T 1 t't': 15.70 I. ,.. (1" L j, :.i;:: r.5/il61GS LhTI.,l,:>r,jL Ii,':':' T,d ~ ., J~.' \J 3.60 '~I \I Co, .1) :5/1J0/'J5 Cle I~AtJC J 05/~6/"~ hA,\lrl~I,;~ TA':'L~l 1 :::.j,"i; 15.70 15/01l/lf5 CI0 ASIO 1 05/06/9;; ASf' 1,.;1 t, ~. C . 1 ~BL~l .. .C:',... 0.00 .'.l C );'.1 15100/95 CIO VE.t\~ 3 05/06195 VH,w~!lIL "L1~T .hc.L. ; .~ ~i 2.. Orj:; 3.60 ISIOu/';5 (10 GL 10 2 u5/U6/~5 (jUPllIOt TAL,L ::. T 1 (,t.: G 7.20 15/0li/Y5 CIO H.ll0J3 05/116/c, T~:~ lI.lOSIt.; II'YT;., h T,;'-LET 1 f'(: 15.70 15/C!SI9~ (10 LI So :~ 05/06/0; Ll3I...'jt>~'IL I 2:-.':~ T.~!L ?t; :..c 3.60 15/001'15 CIa f:A"!U 1 05/0!'>/") hA;{lTIL'I/oi'2 TA~tLE'r j 5 Ol~;:' 15.70 CONT INUEO 12.129/96 'ATlt:.HT lUMotR 775 ACCOU/ll Ti<ANSF~i{ 1 r, 'iAr., ".. i ~ OAT': 2129/96 fJA1IE~IT rlA11F. PAT eRD STrH NUl' J ISCHARGE BID TYPL FlC ~\) ,;111' STHlS OHE AGENT )0;7104-& II Ly,~'4 JR. Y.L1NC' 1 () 'i 4 1 ;' ~ iJ 5/011/95 E026 ,c:>PONSIl"LE i'A"lTY IIJFOliHATIllf4 : H LYNN JR. ~Ll~~ Ill) 2 BO}\ 3M LOY:,V IL LE, i' A (717) 7B9-357~ 1704 7 PATIENT HIFL'\I~1.T l,j'l: ~[)i1 Fe ~,O :;0 ,'\ oACi " .:u:: q M SI,'" 1~4-3o-6632 lJI:' Sf 02 CNTy 184 ACCT nE~ M/~I 104257 f)i\1I 3'1031 KlUFFI',,'J, "'lLLlA:, S /If) DOli 02120/46 p..e 0005-A DAYS 0002 AIi~; OT 05/0';/'15 LST ST:'.T IH 0?/19/96 .;c*>:< e HAP,G ES ~*::c 'OST I NG CHAR GE. SERVICE lATE CODE DATE HCHNICAL DE SCPO 1 PTT ON AHOUNT 1~/Oo/9~ CIO 55032 05/06/95 STA T 15.50 15/00/95 CIO 55028 05/06/95 j>RlJTtI!\CJHtilN TI MF. 15.90 15/0"'/'}~ CIO 55034 05/06/95 APTT 20.50 ,5/01./oJ5 CIO 552i: 2 05/06/95 MAG NES 1 UN 26.10 15/0U'15 CIO 55220 05/06/95 cPr, SE"UM 22.20 ,5/01:/'15 CIO 56HO 05/06/95 CP" ,~" COflPONrNT 31.00 15/03195 CIa 55236 05/06/95 LDti TOTAL 18. 1'0 1~/G,,/<;5 CIO 5640 c: 05/06/95 LOri ISOENZYME C OhPU NU"T 30.00 15/0d/9$ CIO 550:;5 05/06/95 CBe 24.20 15/0US'5 CIO 552" 3 05/06/95 MET ABOL Ie PROF I LE 25.00 15/0(,/:;~ CIe 5581 ;> 05/06/95 5P",CIAL HA i~OLI:, G 12.90 15/01'./<;5 CIi) 55000 05/06/95 PHL F.ijOTO~,Y Fcc 6.60 15/UU95 CI0 55000 05/06/95 I"HLEdOTONY FEE 6.60 15/0U'!5 CIO 551312 05/06/95 SPECIAL I1ANDLlIHi 12.90 15100/95 CIO 55512 05/06/95 SPECIAL H~rjQLlI~G 12.90 15/0b/95 CIO 55034 05/06/95 APTT 20.50 i5/0t/liS CI0 55034 05/06/95 APTT 20.50 '5/06/95 CI2 ASAO 1 05/07/95 ASPIRIN E. C. T AALET 3 2 r;:~:i 0.00 15/01:./95 CI2 VE"lO 3 05/07/95 VErlAPAMIL SUSf.REL. T A,; ?4 O~I:; 3.60 15/0<1/'15 CI2 GL 1 0 2 05/07/95 GLlPIlJOi: T AcL:.. T 1011(; 7.20 15/06/95 CI2 TEf!03 05/07/95 lE~AlGSIh IHYT~Ih Tl.f L:T 1 ~ '.i 15.70 15/01.i/9~ C12 LI 503 OS/07/95 LI::; INOP'RIL IlFSTr:IL ?fj !-4'.i 3.60 I.snJ/9S CI2 RANO l 05/07/95 f'A',ITIC,W;; T,\~ L ET 150\t"., 15.70 15/00/95 CI2 55000 05/0(,1';'5 PrlL I:',',OT O,~Y F~t 6.60 15/0d/ljo5 C12 55'112 05/06/95 SPc.Cll.L HAllOL I,;G 12.90 ,5/01:/95 CI2 5505' 05/06/95 APTT 20.50 ;5/0,,/95 CI2 5S034 05/06/95 APTT 20.50 15/0~/'i5 CI2 5~2li 2 05/06/9::' H,~:,~t::S 1 Uh 26.10 ,:)/G,,/<;5 CI2 55220 05/06/"5 CPI; :;Ei<Uh 22.20 15/01.1'.15 CIt' 56410 05/U"/"5 Co, M~ CU;"'fl()~1~ ~.IT 31.00 I ~/lJ:;/l}5 CIl 5 S 2~ 6 OS/06/95 Un Tel AL lS.10 )5./0 "'95 CI2 5640'1 05/06/95 V);! ISuF.NlY".: '~O.'i;le Nt)~ r 30.00 15/00/';5 CI2 55(JOO OSII,7/95 PHLEJOT O,<,Y F:.; 6.60 ,5/Ud/'15 CIi' 55&1 ? 05/07/~5 ::'Pt CIAL tiA"DLI i,~ 12.90 15/00/';5 C12 5S0~~ OS/()7/9~ CBC 24.20 )5/'~ 5/'}S CI? 5~03L. G5/07/"5 APTl 20.50 j;/Jil/'i5 CI2 5S0~4 05/07/'i~ ~nT 20.50 0212'1/96 PATlt.NT NUMiliR 775 POSTING UATE ACCOUNT T"A"~Ff~ T~ BAO Df~rS D~rr: 2/29/96 PATT!:.NT IlAMr- PAT (RD 5THT r.IIM tlISCIfAIHiE B/O TYPE F/C CO GRP STilTS OATE AGENT 1 1,0 I. H 5 05/06195 E026 PATIENT INF0RM.TIO~: AI)M FC 60 5'::",~ ::t.CE 10/ "'fAR ST ~ $11'/ IJ4-36-o63? 1)1$ ST 02 (NTY 1114 ACCT Kl'P rI/~(~ 104257 Dk# 39Q~1 KAUFFH^~, VILLIAM 5 /10 CuP 02/~O/4~ "~ 0005-A uAYS 0002 Aufl DT 05/06/95 LSl Sj~!T DT 02119/96 17047 <<,~" CHARGES ,,** CHAR c,t SEI?V I CF. COvE' DATE TECHNICAL DESC~IPTI0N 897164-8 H LYNN Jk. KLING RE5PONSIuLE PA~TY INFonHATION : R L YNr~ JR. "UNG RD 2 BOX 360 LOY5VILLE, i'A (717) 709-,~S75 u5/0d/yS C12 5S112 05/08/95 CI2 55244 05/00/95 R79 b0352 05/0b/95 R79 800$2 05/0d/95 R79 7b030 05/0C/95 RN 79021. 05/0b/95 R79 79315 05/08/95 R75 eU352 05/0~/95 R75 7e320 05/00/95 R75 743YC uS/Oo/95 R7S 2u\>:'0 05/0b/95 R75 20057 05/0b/95 R75 2b042 05/00/95 R75 79150 05/00/95 PHO 7bQO 1 u5/0c/95 PHO 7b113 05108/95 PHO 19~V5 05/08/95 PHO 1961: 05/09/95 CIa SAL~1 05/0Y/95 CIO GLIO? 05/09/95 CIO ASA01 05/0Y/Y5 CIO Vi:.r-:u3 OS/09/Y5 CIO GLI02 D5/09/~5 CIa T~R03 u5/0Y/yS CIn LISO] 05/09/95 CI0 RANal 05/09/95 CIO 550s~ 05/0~/95 cIa 5503~ OS/0~/~5 CIO 5~054 05/11/15 CIa s~o~c O~/1l/95 CIO SYlvO 05/11/95 CIO 55~12 05/11/95 CIO 550~O 05/11/Y5 C10 ~)000 05/11/Y5 CI0 55~12 OS/ll/~S CIa 5500fo 05/07/95 UQINALYSIS RUUTlNi: 05/07/'1S (HtMI51RY PROFIL~ 05/07/'15 1V SOL 5()~ CHL 0.9:; ~I)O I;,L 05/07/95 KIT STARTER O~E: TOUCH 10-?99 P5/07/~5 kIT SP~CI~EN ~IO-STP~tM 05/07/95 CUFF AIJULT OISP N~R~1I0TE (S/07/95 URINAL DISP 05/U6/95 IV SOL SOD ChL 0.0= sou KL 0~/06/Q5 IV AD~IN CHEC~ VALVE S~T 28-tO-264 OS/D6/95 OXIMeTRY ~EASU~EHF~T GS/06/95 6ATROCCULT SLI~E 05/06/05 [0 BLOOD PkESSuRl riChlTOR C5/06/95 tD [KG MONITOR 05/06/95 POJCh lELEHET~Y l15/0Cl/95 t::K(; 05/0'1/05 IV PUMP INFUSION SeRVIce TTrM cs/aR/95 ~O~INYASIYE 8P HOHlrORI~G os/oe/?5 CONTINUOUS EKG HONIT0RING 05/06/95 SG~IUK ChLOPIDE 14JECTIO~ 1DYL 05/06/95 GLIPIZIDE TA6Li:.T 10~G 05/a8/95 ASFIi\IN c..C. TA8L;:T 3Z'i'1~ 05/08/95 VE~APA~IL 5UST.RtL. TAc ?~OMG OS/OR/I'S 6LIPIlIDt T~~LtT IGMG 03/u8/95 TERAlOSIN /HYTRIN TA~LFT l~~ D5/0~/Q5 LI~INOPRIL /L~ST~IL ~OMG C5/08/a5 "A~ITI~INE T~~LET l'i0N~ 05/07/95 ~[>TT 0)/08/1'5 c.r 05/U3/05 APTT (1~I/UI;I'~) j.'''Lf''c-110'1Y F ,- C5/~6/~5 ~~Lr~)1.0MV F~~ OS/il6/"S SPECIAL h~i,L'Lllll; 05/07/05 f'HLE"OIOtlY rt:; ~)/~7/a5 P~LE~JTnHY FE! eS/07/?) SPECIAL hA~0LIN~ n5/0~/o5 frlLE~~TO~Y F~r I."T CI1/,i-::;ES/C"f.i;lIS 'JUT 'I"TAIL!::(), A HOU N T 14.30 29.80 30.16 77.40 7.95 18.70 4.35 30.16 37.40 52.50 3.55 24.05 48.70 7.95 70.50 16.00 11.50 11.50 7.85 3. 60- 0.00 3.60- 7.20- 15.70- 3.60- 15.70- 20.50 24.20 20.50 '6.60 6.60 12.90 6.60 6.60 12.90 6.60 3643.12- CARLISLE HOSPITAL PRINT PATIENT MASTER NOV 19, 1997 10:52 PAGE 4 CHARGES AMT DUE PAYMENTS NET CHGS ROOM CHGS PREV BAl 8156.00 .00 .00 1896.00 8156.00 000 ELECTRONICAllY BillED 000 AMOUNT EXT AMT SRV OT PST DT BAT REFERENCE DESCRIPTION ,~O 3 J7 6324 tNT NAME JR, R.l YNN ,EC . 184366632 NRV CHG OTY 301 56410 301 55236 301 55236 301 56409 301 56409 , 301 55283 301 55812 301 55000 301 55283 301 55000 301 55283 301 55000 301 55283 305 55032 305 55028 305 55034 305 55035 305 55032 306 55519 307 55112 307 55112 320 60055 340 66116 340 76013 410 74017 450 26730 450 26037 460 74390 480 76012 480 76015 480 76006 621 79150 636 DIP53 730 26042 732 19700 732 19700 940 13596 940 13598 940 13596 940 13598 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 3 1 1 1 1 1 1 1 6 1 1 1 1 1 1 1 38.00 22.00 22.00 37.00 37.00 31.00 16.00 9.00 31.00 9.00 31.00 9.00 31.00 18.00 19.00 26.00 30.00 18.00 51.00 17.00 17.00 116.00 1443.00 388.00 6.00 221.00 29.00 65.00 185.00 185.00 591.00 8.00 51.00 60.00 202.00 202.00 14.00 14.00 14.00 14.00 00 END OF CHARGES 00 38.00 071897 22.00 071897 22.00 071897 37.00 071897 37.00 071897 31.00 071897 16.00 071897 9.00 071997 31.00 071997 9.00 072097 31.00 072097 9.00 072197 31.00 072197 18.00 071797 19.00 071797 26.00 071797 30.00 071797 18.00 071797 51.00 071997 17.00 071797 17.00 071997 116.00 071997 1443.00 072197 388.00 072197 18.00 071797 221.00 071797 29.00 071797 65.00 071797 185.00 071797 185.00 071797 591.00 071797 8.00 071797 306.00 072197 60.00 071797 202.00 071997 202.00 072097 14.00 071897 14.00 071897 14.00 071997 14.00 071997 0/5 INS .00 072197 C 10 072197 CIO 072197 CIO 072197 CIO 072197 CIO 072197 CIO 072397 CIO 072197 CIl 072197 CIl 072197 CI2 072197 CI2 072297 C 10 072297 C 10 071897 C 10 071897 C 10 071897 CIO 071897 C 10 072397 C 10 072197 CIl 071897 C 10 072197 CIl 071997 PHO 072197 PHO 072197 P HO 071897 R37 071797 PHO 071897 R37 071897 RJ7 071797 PHO 93320 071797 PHO 071797 PHO 93350 071897 R37 072297 CIO INTFCE CHG 071897 RJ7 072097 PHO 072097 PHO 071897 PHO 071897 PHO 071997 PHO 071997 PHO INTFCE CHG CPK MB COMPONE~T I NTFC E CHG lOH TOTAL INTFCE CHG lDH TOTAL INTFCE CHG lDH ISOENZYME COMPONENT I NTFC E CHG lDH ISOENZYME COMPONENT I NTFC E CHG METABOLIC PROF ILE INTFCE CHG SPECIAL HANDLING INTFCE CHG PHLEBOTOMY FEE INTFCE CHG METABOLIC PROFILE INTFCE CHG PHLEBOTOMY FEE I NTFCE CHG METABOLIC PROF ILE INTFCE CHG PHLEBOTOMY FEE INTFCE CHG METABOLIC PROFILE I NTFC E CHG ST AT INTFCE CHG PROTHROMBIN TIME INTFCE CHG APTT I NTFCE CHG CBC I NTFCE CHG STAT INTFCE CHG CULT URINE COLONY CT IDENT INTFCE CHG URINALYSIS ROUTINE INTFCE CHG URINALYSIS ROUTINE 71020 CHEST ROUTINE 2V SPECT THAL PERSAN DIPYRAMIDOLE THALLIUH TEST OXYGEN HOURLY CLASS III VISIT EHERGENCY" ED BLOOD PRESSURE MONITOR DXIHETRY HEASUREHENT CARDIAL DOPPLER DOPPLER COLOR FLOW CARDIAC ECHO 2D/H POUCH TElEHETRY DIPYRIDAMOLE IPERSANTINE ED E KG HON nOR TELEHETRY TE LEHE TRY NONINVASIVE BP CONTINUOUS EKG NONINVASIVE BP CONTINUOUS EKG HONITORING HON ITOR ING HONITOR ING HON ITOR ING 11/19/97 NOV 19, 1997 10:5Z CF .PB0610.! CARLISLE HOSPITAL PAGE 3 PRINT PATIENT ~ASTER PATIENT NO 3376324 CIlARGES PATIENT N A M E AMT DUE PAYMENTS NET CHGS ROOM CIlGS PREV BAL 0/5 INS KLING JR, R.LYNN 8156.00 .00 .00 1896.00 8156.00 .00 SOC SEC r 18436663Z 000 ELEC TRONIC ALL Y B ILLEO 000 NRV CHG DTY AMOUNT EXT AMT SRV OT PST OT BAT REFERENCE OESCRIPTION Z50 GLlOI Z Z.OO 4.00 07Z397 07ZZ97 C 10 I NTFC E CHG GLIPIZIDE TABLET Z50 FUROZ 1 Z.OO 2.00 07Z397 07ZZ97 C 10 I NTFCE CHG FUROSEMIDE TABLET Z50 POT06 I Z.OO Z.OO 07Z397 07ZZ97 CIO I NTFC E CHG POTASSIUM CL S-R TABLET ZO Z50 RXCOl 1 Z.OO Z.OO 07Z397 07ZZ97 CIO I NTFC E CHG MEDICATION - NON-FORMULARY Z58 80J5Z I JZ.OO 3Z.00 071797 071897 R37 IV SOL SOD CHL'0.9~ 500 ML Z70 80Z99 1 90.00 90.00 071797 071897 CIO I NTFCE CHG I.V. THERAPY SERVICE Z70 78113 1 9.00 9.00 071797 071B97 R37 IV PUMP INFUSION SERVICE I Z70 78440 1 8.00 8.00 071797 071897 R37 IV ACCESS INTERLINK INJECT 270 78444 1 3.00 3.00 071797 071897 R37 IV ACCESS NEEDLE LOCK PROC Z70 78443 1 3.00 3.00 071797 071B97 R37 IV ACCESS INTERLINK CANNUL Z70 80Z99 1 90.00 90.00 071897 071897 CIO I NTFC E CHG I.V. THERAPY SERVICE 270 78113 1 9.00 9.00 071897 071897 PHO IV PUMP INFUSION SERVICE I 270 80081 Z 3.00 6.00 071897 071897 PHO FINGER STIX 8LOOD SUGAR SE Z70 79070 1 3.00 3.00 071897 07ZZ97 R75 GRADUATE DISP Z70 790Z4 1 ZO.OO ZO.OO 071897 07ZZ97 R7S CUFF ADULT DISP MARQUETTE Z70 78113 1 9.00 9.00 071997 071997 PHO IV PUMP INFUSION SERVICE I Z70 80081 Z 3.00 6.00 071997 071997 PHO FINGER STIX BLOOD SUGAR SE Z70 80Z99 1 90.00 90.00 071997 07Z197 C 10 I NTFC E CHG I.V. THERAPY SERVICE ,270 80Z99 1 90.00 90.00 07Z097 07Z197 CIO I NTFCE CHG I.V. THERAPY SERVICE Z70 80Z9? 1 90.00 90.00 07Z197 07 Zl97 CI1 I NTFCE CHG I.V. THERAPY SERVICE z'70 80Z99 -1 90.00 -90.00 07Z197 07ZZ97 C 10 I NTFC E CHG I.V. THERAPY SERVICE Z70 80Z99 1 90.00 90.00 07ZZ97 07Z197 C IZ I NTFC E CHG I. V. THERAPY SERVICE 270 80Z99 1 90.00 90.00 07Z397 07ZZ97 C 10 I NTFCE CflG I.V. THERAPY SERVICE Z7Z 788Z0 1 30.00 30.00 071797 071897 R37 CATHETER TRAY FOLEY 18 FR ) 301 55000 1 9.00 9.00 071797 071897 C 10 I NTFC E CHG PHLEBOTOMY FEE 301 55Z8Z 1 JZ.OO 3Z.00 071797 071897 CIO I NTFCE CHG MAGNESIUM 301 55ZZ0 1 Z 8.00 Z 8. 00 071797 071897 C 10 I NTFC E CHG CP K SERUM ) 301 56410 1 38.00 38.00 071797 071897 C 10 I NTFCE CHG CPK MB COMPONENT 301 S5Z36 1 Z2. 00 ZZ.OO 071797 071897 CIO I NTFCE CHG LDH TOTAL 301 56409 1 37.00 37.00 071797 071897 C 10 I NTFC E CHG LOH ISOENZYME COMPONENT } 301 55Z83 1 31.00 31.00 071797 071897 C 10 I NTFC E CHG ME TABOLlC PROF ILE 301 55000 1 9.00 9.00 071797 071B97 C 10 I NTFC E CHG PHLEBOTOMY FEE 301 558lZ 1 16.00 16.00 071797 071897 CIO I NTFC E CHG SPECIAL HANDLING ) 301 55Z8Z 1 JZ.OO 3 Z. 0 0 071797 071897 C 10 I NTFC E CHG MAGNESIUM 301 55ZZ0 1 Z8.00 Z8.00 071797 071897 C 10 I NTFC E CHG CPK SERUM ',301 56410 1 38.00 38.00 071797 071897 C TO I NTFC E CHG CPK MB COMPONENT ;l01 55ZJ6 1 Z2.00 Z Z. 00 071797 071897 CIO I NTFC E CHG LOH TOTAl 30J, 56409 1 37.00 37.00 071797 071897 C 10 I NTFC E CHG LDH ISOENZYME COMPONENT 30i. 55000 1 9.00 9.00 071897 07Z197 C 10 I NTFC E CHG PHLEBOTOMY FEE 301 .55000 1 9.00 9.00 071897' 072197 CIO I NTFC E CHG PHLEBOTOMY FEE 301 S 58lZ 1 16.00 16.00 071897 07Z197 CIO I NTFC E CHG SPECIAL HANDLING 301 5\5Z82 1 32.00 3Z.00 071897 07Z197 CIO I NTFCE CHG MAGNESIUM 301 5.~Z82 1 32.00 32.00 071B97 07Z197 CIO I NTFC E CHG MAGNESIUM 301 B 282 1 JZ.OO 3 Z. 0 0 071B97 07 Zl97 C 10 I NTFC E CHG MAGNESIUM 301 55'Z20 1 28.00 28.00 071897 072197 C 10 I NTFCE CHG CPK SERUM 301 55!?-ZO 1 28.00 28.00 071897 07Z197 CIO I NTFCE CHG CPK SERUM 301 561,i10 I 38.00 38.00 071897 07Z197 C 10 I NTFC E CHG CPK MB COMPONENT j / ) \ 11/19/97 CF.PB0610.1 PATlENT NO 3376324 PAT I E N T N A H E KLING JR, R.LYNN SOC SEC' 184366632 NRV CHG Q TV 2S0 ACE02 4 250 HET50 1 250 ASAOl 1 250 L1S02 2 250 GLIOl 2 250 TER03 2 250 L1S02 2 250 FAHOl 1 250 GLI 01 2 250 FUR02 1 250 POT06 1 250 RXCOl 1 250 RXCOl 1 250 ASAOl 1 250 L1S02 2 250 GLIOl 2 250 FUR02 1 250 POT06 1 250 TER03 2 250 L1S02 2 250 'FAHOl 1 250 GLI 01 2 250 RXCOl 1 250 RXCOl 1 250 TER03 -2 250 ASAOl -1 250 L1S02 -4 250 FAHOl -1 250 GLIOl -4 250 FUR02 -1 250 POT06 -1 250 RXCOl -2 250 SAL61 1 250 CHG08 1 250 ASAOl 1 250 L1S02 2 250 GLIOl 2 250 FUR02 1 250 POT06 1 250 RXCOl 1 250 TER03 2 250 LIS02 2 250 FAHOl 1 250 GLI 01 2 250 RXCOl 1 250 ASAOl 1 250 L1S02 2 AHOUNT .00 2.00 .00 4.00 2.00 8.00 4.00 2.00 2.00 2.00 2.00 2.00 2.00 .00 4.00 2.00 2.00 2.00 8.00 4.00 2.00 2.00 2.00 2.00 8.00 .00 4.00 2.00 2.00 2.00 2.00 2.00 15.00 6.00 .00 4.00 2.00 2. DO 2.00 2.00 8.00 4.00 2.00 2.00 2.00 .00 4.00 CARLISLE HOSPITAL PRINT PATIENT ~ASTER NOV 19, 1997 10:52 PAGE 2 CHARGES PREV 8AL B156.00 OIS INS .00 AHT OUE PAYHENTS NET CHGS ROOH CHGS 8156.00 .00 .00 1896.00 .00 ELECTRONICALLY BILLED ... EXT AHT SRV DT PST OT BAT REFERENCE DESCRIPTION .00 071997 072297 CIO INTFCE CHG ACETAHINOPHEN TABLET 650HG 2.00 071997 072891 PI2 INTFCE CHG HETOCLOPRAHIDE INJECTION .00 072097 072197 CIO INTFCE CHG ASPIRIN E.C. TABLET 325HG 8.00 072097 072197 CIO INTFCE CHG LISONIPRIL IPRINIVIL 5HG 4.00 072097 072197 CTO INTFCE CHG GLlPIZIDE TABLET' 16.00 072097 012197 CIl INTFCE CHG TERAIOSIN IHYTRIN TABLET 8.00 071097 072197 CIl INTFCE CHG LISONIPRIL IPRINIVIL 5HG 2.00 072097 072197 CIl INTFCE CHG FAHOTIDINE TABLET 4.00 072097 072197 CIl INTFCE CHG GLIPIIIDE TABLET 2.00 072097 072197 CIl INTFCE CHG FUROSEMIDE TABLET 2.00 072097 072191 CIl INTFCE CHG POTASSIUM CL S-R TABLET 20 2.00 072097 072197 CI2 INTFCE CHG MEDICATION - NON-FORMULARY 2.00 072091 012197 CI2 INTFCE CHG MEDICATION - NON-FORMULARY .00 072191 072197 CIl INTFCE CHG ASPIRIN E.C. TABLET 325MG 8.00 072197 012197 CIl INTFCE CHG LISONIPRIL IPRINIVIL 5HG 4.00 012197 072191 CIl INTFCE CHG GLIPIIIDE TABLET 2.00 012191 072197 CIl INTFCE CHG FUROSEMIDE TABLET 1.00 072197 012197 CIl INTFCE CHG POTASSIUM CL S-R TABLET 20 16.00 072197 072191 CI2 INTFCE CHG TERAIOSIN IHYTRIN TABLET 8.00 071197 072191 CII INTFCE CHG LISONIPRIL IPRINIVIL 5MG 2.00 072197 072197 CI2 INTFCE CHG FAMOTIDINE TABLET 4.00 072197 072191 CI2 INTFCE CHG GLIPIIIDE TABLET 2.00 072197 012197 CI2 INTFCE CHG HEDICATION - NON-FORHULARY 2.00 072197 012191 CI2 INTFCE CHG HEDICATION - NON-FORHULARY -16.00 072197 072291 CIO INTFCE CHG TERAIOSIN IHYTRIN TABLET .00 012191 012297 CIO INTFCE CHG ASPIRIN E.C. TABLET 325MG -16.00 072197 072297 CIO INTFCE CHG LISONIPRIL IPRINIVIL 5MG -2.00 072197 012297 CIO INTFCE CHG FAHOTIDINE TABLET -8.00 012197 072291 CIO INTFCE CHG GLIPIIIDE TABLET -2.00 012191 012297 CIO INTFCE CHG FUROSEMIDE TABLET -2.00 012197 072297 CIO INTFCE CHG POTASSIUH CL S-R TABLET 20 -4.00 072197 072297 CIO INTFCE CHG HEDICATION - NON-FORHULARY 15.00 072197 012297 CIO INTFCE CHG SODIUH CHLORIDE INJ 6"00 071191 072291 CIO INTFCE CHG PHARHACY CHARGE IV SYRINGE .00 012297 072197 ~I2 INTFCE CHG ASPIRIN E.C. TABLET 325MG 8.00 012297 072191 CI2 INTFCE CHG lISONIPRIl IPRINIVIl 5HG 4.00 072297 012197 CI2 INTFCE CHG GLIPIIIOE TABLET 2.00 072297 072197 CI2 INTFCE CHG FUROSEHIDE TABLET 2.00 072297 072197 CI2 INTFCE CHG POTASSIUH Cl S-R TABLET 20 2.00 072297 072191 CI2 INTFCE CHG HEDICATIDN - NON-FORHULARY 16.00 072297 012297 CIO INTFCE CHG TERAIOSIN IHYTRIN TABLET 8.00 072291 012291 CIO INTFCE CHG lISONIPRIL IPRINIVIl 5HG 2.00 012291 012291 CIO INTFCE CHG FAHOTIDINE TABLET 4.00 072297 012297 CIO INTFCE CHG GLIPIIIDE TABLET 2.00 012297 012291 CIO INTFCE CHG HEDICATION - NON-FORHULARY .00 072397 012297 CIO INTFCE CHG ASPIRIN E.C. TABLET 325HG 8.00 072391 072291 CIO INTFCE CHG lISONIPRIl IPRINIVIL 5HG 11/19/97 CF.PB0610.1 PATIENT NO 3376324 PATIENT NAME KLING JR. R.LYNN SOC SEC' IB4366632 NRV CHG QTY 120 13500 1 120 11500 1 120 11500 1 206 13500 1 250 HAG50 1 250 HAG50 1 250 DEX61 1 250 DEX61 1 250 CHG05 1 250 CHG05 1 250 TER03 2 250 FUR53 1 250 ASAOI 1 250 LIS02 2 250 L1S02 2 250 FAKOl 1 250 GLlOl 2 250 FUR52 1 250 HOR50 1 250 LOR02 1 250 NTG60 1 250 ASAOl 1 250 FUR52 1 250 TER03 2 250 FUR53 1 250 ASAOl 1 250 L1S02 2 250 GLlOl 2 250 NTG70 1 250 L1S02 2 250 L1S02 -2 250 F AMOl 1 250 GLlOl 2 250 HAG50 1 250 DEX61 1 250 CHG05 1 250 HOK20 1 250 HET50 1 250 TER03 2 250 ASAOl 1 250 L1S02 2 250 L1S02 2 250 FAKOl 1 250 GLlOl 2 250 GLI 01 2 250 FUR02 1 250 POT06 1 AHOUNT 416.00 416. DO 416. DO 648.00 2.00 2. DO 15.00 15.00 6.00 6.00 8.00 4.00 .00 4. DO 4.00 2. DO 2.00 2.00 5.00 5. DO 21.00 .00 2.00 8. DO 4.00 .00 4.00 2. DO 10.00 4.00 4.00 2. DO 2.00 2. DO 15. DO 6.00 2.00 2. DO 8.00 .00 4.00 4.00 2.00 2.00 2.00 2.00 2.00 CARLISLE HOSPITAl PRINT PATIENT ~ASTER NOV 19, 1997 10:52 PAGE 1 AMT DUE 8156.00 CHARGES PREY BAL B156.00 O/S INS .00 PAYHENTS NET CHGS ROOK CHGS .00 .00 1896.00 UQ ELECTRONICALLY 81LLED 000 EXT AHT SRV OT PST DT BAT REFERENCE DESCRIPTION 416.00 071897 071B97 RBO 01050 1200 ROOK-BED 416.00 071997 071997 RBO 02240 1200 ROOK-BEO/KSII 416.00 072097 072097 RBO 02240 1200 ROOM-BEO/MSII 648.00 071797 071797 RBO 01050 2060 ROOK-BED 2.00 071797 071897 CIO INTFCE CHG HAGNESIUH SULFATE 50~ INJ 2.00 071797 071897 CIO INTFCE CHG MAGNESIUM SULFATE 50~ INJ 15.00 071797 071897 CIO INTFCE CHG DEXTROSE 5:: WATER 15.00 071797 071897 CIO INTFCE CHG DEXTROSE 5~ WATER 6.00 071797 071897 CIO INTFCE CHG PHARHACY CHARGE IV AOOITIV 6.00 071797 071897 CIO INTFCE CHG PHARHACY CHARGE IV ADDITIV 16.00 071797 071897 CIO INTFCE CHG TERAZOSIN /HYTRIN TA8LET 4.00 071797 071897 CIO INTFCE CHG FUROSEHIDE INJECTION /LASI .00 071797 071B97 CIO INTFCE CHG ASPIRIN E.C. TABLET 325MG 8.00 071797 071897 CIO INTFCE CHG LISONIPRIL /PRINIVIL 5MG 8.00 071791 071B97 'CIO INTFCE CHG LISONIPRIL '/PRINIVIL 5KG 2.00 071797 071897 CIO INTFCE CHG FAMOTIDINE TABLET 4.00 071197 071897 CIO INTFCE CHG GLIPIZIDE TABLET 2.00 071797 072197 PI3 INTFCE CHG FUROSEMIDE INJECTION 5.00 071797 072197 PI3 INTFCE CHG MORPHINE INJECTION 5.00 071797 072197 PI3 INTFCE CHG LORAZEPAH TABLET 21.00 071797 072197 PI3 INTFCE CHG NITROGLYCERIN INJ 50MG/250 .00 071797 072197 PI3 INTFCE CHG ASPIRIN E.C. TABLET 325MG 2.00 071797 072197 PI3 INTFCE CHG FUROSEMIDE INJECTION 16.00 071897 071897 CIO INTFCE CHG TERAZOSIN /HYTRIN TA8LET 4.00 071897 071897 CIO INTFCE CHG FUROSEMIDE INJECTION /LASI .00 071897 071897 CIO INTFCE CHG ASPIRIN E.C. TABLET 325MG" 8.00 071897 071897 CIO INTFCE CHG LISONIPRIL /PRINIVIL 5HG 4.00 071897 071897 CIO INTFCE CHG GLIPIZIDE TABLET 10.00 071897 072197 PI2 INTFCE CHG NITROGLYCERIN TOP. OINT. 8.00 071897 072197 CIO INTFCE CHG LISONIPRIL-/PRINIVIL 5HG -8.00 071897 072197 CIO INTFCE CHG LISONIPRIL /PRINIVIL 5HG 2.00 011897 072197 CIO INTFCE CHG FAHOTIDINE TABLET 4.00 071897 072197 CIO INTFCE CHG GLIPIZIDE TABLET 2.00 071897 072197 CIO INTFCE CHG KAGNESIUM SULFATE 50~ INJ 15.00 071897 072197 CIO INTFCE CHG DEXTROSE 5~ WATER 6.00 071897 072197 CIO INTFCE CHG PHARMACY CHARGE IV AODITIV 2.00 071897 072197 CI2 INTFCE CHG KILK OF MAGNESIA 2.00 071997 072197 PIO INTFCE CHG HETOCLOPRAKIDE INJECTION 16.00 071997 072197 CIO INTFCE CHG TERAZOSIN /HYTRIN TABLET .00 071997 072197 CIO INTFCE CHG ASPIRIN E.c. TABLET 325KG B.OO 071997 072197 CIO INTFCE CHG LISONIPRIL /PRINIVIL 5MG 8.00 071997 072197 CIO INTFCE CHG LISONIPRIL /PRINIVIL 5KG 2.00 071997 072197 CIO INTFCE CHG FAKOTIDINE TABLET 4.00 071991 072197 CIO INTFCE CHG GLIPIZIDE TABLET 4.00 011997 072197 CIO INTFCE CHG GLIPI210E TABLET 2.00 071997 072197 CII I~TFCE CHG FUROSEMIDE TABLET 2.00 071997 072197 CIl INTFCE CHG POTASSIUM CL S-R TABLET 20 . ", " , , ~ -::.:;;r::i':i!)' .. ;',;-.j;.'j'il i.."_:'j U). i:.:"'-"" ...li,l Cll~;E IlO: 1 :';ii_~ ;;,',_j':'~'~' :', ;:,'Clt11';C)H'lvC,)LTll (:F FEr~ll.~~VL':f~ljlil: CIJUr:T'{ ell" CUl'IDEELt'd:L-' C/;[~LE;LE 1 1 0::: f'l TAL /" fiEAL:i'f1 SEE 'IS. KLING H LYNN JR R. Thom,:lS f'~l i.O(:! , Sh'=,riif, whu uC'iflCj duly ~,"'orn according to law, saya, that he madO' a di11gent search and inquiry f01- the with1n nam'?d d<?fendant, to wit: I';LIIIG R LYNN JH but was unable to locate deputi=ed the sheriff of lIim In his bailiwick. lie therefore County, Pennsylvania. PERR'i to serve the vithill C01'IPLAIN1' On rebrUe\rv ::6th, 1990 the attached return from PEHRY this Oi~lC0 WUG in r~ceipt 01 _ County, Penn::iylvania. Sheriff's Costs: So answers:. ./ ~~~d'1u Docketlnq Out of County SurchargE:' P'?rx-y Coun ty 10,00 9.l2jO 6.00 .2:3,00 'fob";;, (,;)t.i i"t1\RTSOil tIEt\RDORFF hflLLltd'lS 02/ :'G/ 1 '396 Sworn and subsc].ib~d Lo be1Qr~ m~ this .:lk I:::' d"i' ,'1 'i.A.,^-"", r~- 19-9i_ A, D. n. a_~!i,y,,_~,:,-_ ~ t-'rot.nullIJt.:.11"Y Carlisle Hospital & Health IN THE COURT OF COMMON PLEAS OF THE 41st JUDICIAL DISTRICT OF PENNSYLVANIA PERRY COUNTY BRANCH Services VtII'lIUS R. Lynn Klfng, Jr, No. 98-777 SHERIFF'S RETURN And now February 24, 1998; Served the within name R. Lynn Kling the defendant(s) named herin, personally at his place of residence in N,E, Madison Twp. Perry County, PA, on February 24, 1998 at 4:30 o'clock PM by handing to Elaine Kling, wife of , an adult member of family 1 true and attested Oaf, copy(ies) of the within Complaint and made known to her the contents thereof Sworn and subscribed to before me this J I) day of Iqqt , So answers, , ,(... 4' //""5' b.,,~) Sheriff of Perry County In The Court of Common Picas of Cumberland County, Pennsylvunia Carlisle Hospital and Health Services VS. R. Lynn Kling, Jr. No. 98-777 Civil Term 19_ Now, Feb. 10, Perry 1991\9_.1 SHERIFF Of CUMBERLAND COUNTY. PA do hereb~' deputize the Sherlrrof County to uecute this Writ. this deputation being made althe request and risk of tbe Plalntlrr. ~fJ?~/~~ SberlrrofCumberland Count)" Pa. Affidavit of Service Now, wltbin upon at by handing to anested copy of the original the contents thereof, 19 . at o'c1ock ;\1. ser"ed the o true ond ond mode known 10 '. So answers, Sherirr of Count)', Po, COSTS Sworn ond suh,crihed hefore me this da~' of 19_ SERVICE MILEAGE AfFlDA "IT s s CARLISLE HOSPITAL AND HEALTH SERVICES, Plaintiff v, IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW NO, 98-777 CIVIL TERM R, LYNN KLING, JR" Defendant JURY TRIAL DEMANDED TO: R. LYNN KLING, JR. You are hereby notified that on --SerkmW 6, has been entered against you in the above-captioned case. ,~1 .ri c:;' (', , the folloWl~~ Ju~~ment: ~'t,; ""Tl l'111~ -0 I>) ....~.. --- :~t r UJ~" O. ;,~: -<.. . ~. ~ c:. _~~ 4,:D - ::=g ~c. ~ ::j -<; (7'\ ": ~!.) :J.....,'.! .... -, ~. t f) U.-I) :;t ~ -< Date: q 1J 01 /sI{!~ f;,(q Prothonotary I hereby certify that the name and address oCthe proper person to receive this notice under Pa. R. Civ. P. 236 is: ,\ , I Mr. R, Lynn Kling Rural Route #2 Box 360 LoysviIle, PA 17047 } \ ' 1'':( i!1 , , n. ii' I', 'I,' i; , i';~ g ,-:;; ~~ - if> j ~n ::i~.. ..., ~ ' ~ , '. ~ Si .,.,ij.: '-0 I;'" ~ Q1fll , ~:? ... "1.1 1 ;':-:',t'') ~.. "-- 0' B -"'T ':1t:. U~ ,: ~:~; "- -<.. .~'i -\J i ~} ...., ....... -0 ~,_. :,: ~-.. 'rn C' ~ 2::~ r:-il i5 ~ ..:., -I 5-'" . ',", -":l ~ ::0. -. "< ~ 0 '3 ~ l1' C) (J c:. + 0 CARLISLE HOSPITAL and HEALTH SERVICES, PLAINTIFF IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA v. CIVIL ACTION - LAW R. LYNN KLING, JR., DEFENDANT 98-777 CIVIL TERM ORDER OF COURT AND NOW, this 30th day of October, 2001, in the case of Carlisle Hospital and Health Services versus Kling at No. 98-777 civil Term, and it appearing that docket activity has recently occurred in the case, the case is stricken from the purge list and shall remain active. By the Court, George B. Faller, Esquire 10 East High Street Carlisle, PA 17013 For the Plaintiff L~J'I1~ , , ')'~'O,- l P1{~ R. Lynn Kling, Defendant Box 360 Loysville, PA 17047 pcb Pro Se (') c:.l C -6 i;J;...., - :os cpr)' ..- :":-~?, '- , .h! U)'~" '.0 :}..::: ;;>;:':- , i (,-l..,' .!f~) ~- }i;; ~I.J -" ,-= () ~c: ~ :-Fn ~ ;:... =:> ". ,;:- ~ 1% ,/