From:

Suite 5A-1204
123 Somewhere Street
Your City AZ 12345

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0023
Invoice Date September 11, 2019
Total Due $626.94
To:
Alexandra Ayala Acosta
Hrs/Qty Service Rate/PriceAdjustSub Total
1 ORTHODONTIC $2,775.750.00%$2,775.75
Sub Total $2,775.75
Tax $0.00
Paid -$2,148.81
Total Due $626.94

Pago Manual