From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0113
Invoice Date April 11, 2018
Total Due $-49.99
To:
Carlos Carrasquillo Medina
Hrs/Qty Service Rate/PriceAdjustSub Total
1 ORTHODONTIC $1,963.000.00%$1,963.00
Sub Total $1,963.00
Tax $0.00
Paid -$2,012.99
Total Due $-49.99

Pago Manual