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Article #48

Health Care - California Residents Only - Blue Shield

#48
From: Ray Stark
Date: Sun, 30 Jul 1995 00:00
27 lines
2035 bytes
Affordable Health Care Coverage: Blue Shield of California.
CALIFORNIA residents only. For a free quote complete form below
and email to: raystark@wco.com

                HEALTH CARE QUESTIONNAIRE
   DATE __  TYPE OF QUOTE DESIRED: HMO ___PPO  ___BOTH ___
   FIRST NAME _ LAST _
   ADDRESS __
   CITY, STATE, ZIP ___
   COUNTY ___ PHONE ___
   FAX ___ E-MAIL __
      AGE __  MARRIED __ SINGLE __
   FAMILY COVERAGE:  
   SPOUSE NAME __ AGE __
   CHILDREN: NAME        AGE
          _________      ________
          _________      ________
          _________      ________
          _________      ________
Stand alone Dental and Vision plan info: __ Yes __ No

Contact Ray Stark at:
Pinole Insurance Services, Inc. 
1660 San Pablo Ave #201 Pinole CA 94564
ph 510.741.8729 fax 510.741.7062 
email: raystark@wco.com
http://www.wco.com/~raystark/
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From: Ray Stark <raystark@wco.com>
Subject: Health Care - California Residents Only - Blue Shield
Date: 1995/07/30
Message-ID: <3vfujd$1ms@news.wco.com>
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