Paid Item Form

Patrons First name: *
Patrons Last Name: *
Patrons Library Card Number: *
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First Title: *
First Barcode Number: *
First Call Number: *
Second Title:
Second Barcode Number:
Second Call Number:
Third Title:
Third Barcode Number:
Third Call Number:
Fourth Title:
Fourth Barcode Number:
Fourth Call Number:
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