From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0074
Invoice Date January 13, 2021
Total Due $100.00
To:
Ariana S. Velez Contreras
Hrs/Qty Service Rate/PriceAdjustSub Total
1 RETAINERS $500.000.00%$500.00
Sub Total $500.00
Tax $0.00
Paid -$400.00
Total Due $100.00

Pago Manual