From:

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

admin@elverdedentalbraces.vivabraces.com

Invoice Number INV-0166
Invoice Date February 21, 2019
Total Due $179.98
To:
Daniela A. Cardona Velazquez
Hrs/Qty Service Rate/PriceAdjustSub Total
1 ORTHODONTIC $2,459.750.00%$2,459.75
Sub Total $2,459.75
Tax $0.00
Paid -$2,279.77
Total Due $179.98

Pago Manual