From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0135
Invoice Date September 16, 2016
Total Due $-637.00
To:
Chandell O. Cruz Garcia
Hrs/Qty Service Rate/PriceAdjustSub Total
1 ORTHODONTIC $1,963.000.00%$1,963.00
Sub Total $1,963.00
Tax $0.00
Paid -$2,600.00
Total Due $-637.00

Pago Manual