From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0068
Invoice Date February 27, 2018
Total Due $460.00
To:
Anthony Santiago Hiraldo
Hrs/Qty Service Rate/PriceAdjustSub Total
1 RETAINERS $500.000.00%$500.00
Sub Total $500.00
Tax $0.00
Paid -$40.00
Total Due $460.00

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