Patient Name : Donald Gardner
Address : B28 University Street US
Phone No : +123 456 7890
Doctor Name : Dr.Helen White
Department : Orthopedic
Invoice No : #1240
Admit Date : 11/07/2020
Discharge Date : 17/07/2020
| No |
Description |
Qty |
Amount |
| 1 |
Pharmacy
|
7 |
$300.00 |
| 2 |
CT Scan
|
1 |
$200.00 |
| 3 |
laboratory
|
3 |
$300.00 |
| 4 |
Medical/Surgical Supplies and Devices
|
- |
$5000.00 |
|
Sub Total |
$5800.00 |
|
Tax Rate |
$0.00% |
|
Total |
$5800.00 |
Terms And Condition :
- All accounts are to be paid within 7 days from receipt of invoice.
- To be paid by cheque or credit card or direct payment online.
- If account is not paid within 7 days the credits details supplied as confirmation
of work undertaken will be charged the agreed quoted fee noted above.
Account Manager
Signature
Thank you very much for doing business with us. Thanks !
