Donations
Pharmacy Project

Donation For
Donation Amount

Did you know that:

$50.00 will support eight (8) patients with nitroglycerin tablet to help prevent heart attacks?

$100.00 supports 36 asthmatic patients with inhalers?

$600.00 provides blood glucose test strips for 24 diabetic patients?

$1,000.00 provides insulin for 40 diabetic patients?

$500.00 patients receive antibiotics for 15 patients?


St. Nicholas Clinic
"A Special Way to Remember"
"A Unique Way to Give"

YOU can donate in Memory of a loved one, friend, or pet:
Loved ones name: ____________________________

Donate in Honor of an individual or organization:
Individual or organization's name: ________________

Donate to Commemorate an event:
Events Name: _______________________________

Amount of Donation in Memory /Honor, Commemorate:
$_________________________
Your Name and address:
_________________________________
_________________________________
_________________________________
Each person or organization you honor or remember will be sent a note of acknowledgement
Mail Acknowledgement To:
___________________________________________
___________________________________________
___________________________________________
Mail to: St. Nicholas Family Clinic, 1901 Kentucky Ave., Paducah, KY 42003


Amount:

OR.....Send us your billing information
Name
Street
City
State
Zip