From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0136
Invoice Date September 25, 2018
Total Due $-359.96
To:
Chantal J. Arbelo Mejias
Hrs/Qty Service Rate/PriceAdjustSub Total
1 ORTHODONTIC $2,459.750.00%$2,459.75
Sub Total $2,459.75
Tax $0.00
Paid -$2,819.71
Total Due $-359.96

Pago Manual