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` ER S' COMPENSATION CLAIMS REPORT <br /> 323 <br /> ' OF ST ANTP ONY :DATE OF dEPORT 02/01 <br /> 2187 T = ° �POLI CY `YR. Obi/0.1/81� 'TO 06/01/B2. <br /> DAYS DATE OF -PAID' TO: .DATE-= --'' ` = TOTAL . -CL" <br /> '`tPTION LOST LOSS MEDICAL INDEM. EXPENSE RESERVE COST ST <br /> 15 07/28/81 445. 45 1415. 20 0. 00 0. 00 1860. 65 C <br /> 12 10129191 168- 49 468. 00 O. 00 333. 51 970- 00 O <br /> %'k."TIPLE' PARTS "0 11/10/81 34. 00 t0 <br /> \CLOSED 'DAYS PAID PAID PAID' y "+ "TOTAL <br /> ' <br /> NO PAY LOST MEDICAL INDEMNITY EXPENSE RESERVE COST <br /> `0 27 $647. 94 $18B3. 20 $0. 00 $333. 51 $2e64. 65 <br /> •1� � 1 i its � J —� fY.�l <br /> ' •'° •, -,. _ - :; ,'�= . _ {r�.�c t4-i`' +fit �.?,ri r y,x`•,j,T`'k�°� , f�: <br /> _ ,.F ,... .�1. .FJ'?'_ -!•�-.. 'd4 c'�._`�x� fia �� ""�°`� Lt_'l.^,�1`Ly.�' <br />