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This payment is going to:
Community Memorial Healthcare (CMH), Inc.
708 N. 18th St
Marysville, KS 66508
Welcome to the Online Payment Center. You may pay your hospital bills here by credit/debit card or check. |
For your convenience please fill out the below payment form. All information will be kept secure and confidential. For more information you may call our business office during working hours.
You may make payments to CMH submitting your credit card or checking account information in below fields.
All payments are via secure server. Thank you for allowing us to serve you.
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Name Of Patient Name of Patient Treated. |
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Patient Account Number Account Number. (Should Be Located On Your Bill) |
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Billing Name Name on Credit Card. |
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Billing Address Address Where Your Credit Card Statements Are Mailed. |
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City, State, Zip Please Include Your City, State, and Five Digit Zip Code. |
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Your E-Mail Address Please Provide An E-mail Address. |
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Route Number Bank Account Route Number |
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Account Number Bank Account Number |
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Amount of Your Payment Please Specify How Much You Are Paying. Please Use Dollars and Cents. |
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Credit Card Type Select If You Are Paying By Credit Card. |
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Credit Card Number Input The 16 Digit Number Exactly As It Appears On Card. |
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Credit Card Expiration Date mm/yy |
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CV3 Code 3-digit code located on the back of your credit card. |
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Comments Or Messages Related To Your Payment |
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