From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0069
Invoice Date November 20, 2018
Total Due $20.00
To:
Anthony Santiago Hiraldo
Hrs/Qty Service Rate/PriceAdjustSub Total
1 BROKEN BRACKETS $40.000.00%$40.00
Sub Total $40.00
Tax $0.00
Paid -$20.00
Total Due $20.00

Pago Manual