Invoice #1015
Oct 4, 2026, 3:20 PM
Summary
Paid
| Item | Qty | Price | Amount |
|---|---|---|---|
| New patient exam, x-rays and cleaning | 1 | $140.00 | $140.00 |
Total$140.00
Paid$140.00
Patient
Name
Email
caleb.carter@example.com
Phone
(630) 555-0122
Payment
Status
Paid
Due
Oct 18, 2026