From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0033
Invoice Date February 18, 2021
Total Due $95.00
To:
Alondra Ayala De Jesus
Hrs/Qty Service Rate/PriceAdjustSub Total
1 RETAINERS $395.000.00%$395.00
Sub Total $395.00
Tax $0.00
Paid -$300.00
Total Due $95.00

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