From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0075
Invoice Date February 12, 2019
Total Due $1,199.80
To:
Ariana Vazquez Torres
Hrs/Qty Service Rate/PriceAdjustSub Total
1 ORTHODONTIC $2,459.630.00%$2,459.63
Sub Total $2,459.63
Tax $0.00
Paid -$1,259.83
Total Due $1,199.80

Pago Manual