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Date on Receipt: VisitDateMonth -- 010203040506070809101112 / Day -- 01020304050607080910111213141516171819202122232425262728293031 / Year -- 20232024

Time on Receipt: Hour -- 010203040506070809101112 : Minute -- 000102030405060708091011121314151617181920212223242526272829303132333435363738394041424344454647484950515253545556575859   Meridiem -- AMPM

Survey Code on Receipt: CN1 - CN2 - CN3