![8456570-fillable-123456789$0-form-allinahealth](https://cdn.cocodoc.com/cocodoc-form/png/8456570-fillable-123456789$0-form-allinahealth-x-01.png)
Billing statement form - hospital bill form
If paying by credit card, fill out below check card using for payment allina hospitals & clinics 2925 chicago avenue minneapolis, mn 55407-1321 card number exp. date m m y y amount paid signature billing questions? please call us at 612-262-9 or...
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