From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0147
Invoice Date October 16, 2017
Total Due $-350.00
To:
Claudia Moyette Baez
Hrs/Qty Service Rate/PriceAdjustSub Total
1 ORTHOPEDIC $400.000.00%$400.00
Sub Total $400.00
Tax $0.00
Paid -$750.00
Total Due $-350.00

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