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Joint Photographic Experts Group Image  |  1999-05-14  |  28KB  |  232x288  |  16-bit (27,124 colors)
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OCR: «Blood/mnd .Sur gical dressty splinte. trusses. crutches or heart poc Portos and medicines that require a prescription, are purchased upon a physician's order and dispensed by @ licensed pharmacist. Up to a calendar vear maximum $5.000. .Hospice Cores .Home Health Care. TOTAL ANDIUAL FREMIUM. .. . .... TOTAL, SEMI-ANNUAL PREMIUMI. TOTAL ASP/PRD PREMIUM ..