From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0108
Invoice Date May 9, 2018
Total Due $239.96
To:
Carisveth A. Bermudez Zayas
Hrs/Qty Service Rate/PriceAdjustSub Total
1 ORTHODONTIC $2,459.630.00%$2,459.63
Sub Total $2,459.63
Tax $0.00
Paid -$2,219.67
Total Due $239.96

Pago Manual