Planned Parenthood Receipt

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Branch / Organization Code

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City, State, ZIP

Patient Name

Account ID

Transaction Date

Response

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Account Holder

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Transaction Amount

Authorization Code

Time

Response Code

Receipt Date

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EMV Value 1

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I agree to the Terms of Service and confirm legitimate use only.

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PPMNS

671 Vandalia Street

Saint Paul MN 55114-1312

Patient Name:ALEXANDRA SMITH

Account ID:ACCT-782349

Transaction Date:08/15/2025

Response:Approval (00)

Transaction Type:Payment

Account Holder:ALEXANDRA SMITH

Card Number:************4922

Transaction Amount:$718.00

Authorization Code:AUTH827364

Time:10:42:37 AM

Response Code:00

EMV:

AID:A0000000980840

TVR:8000048000

IAD:06010A03600000

TSI:6800

ARC:00

Date08/15/2025

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