Invoice #1033
Oct 31, 2026, 8:10 AM
Summary
Paid
| Item | Qty | Price | Amount |
|---|---|---|---|
| Composite filling | 1 | $350.00 | $350.00 |
Total$350.00
Paid$350.00
Patient
Name
Email
rachel.mitchell@example.com
Phone
(630) 555-0131
Payment
Status
Paid
Due
Nov 14, 2026
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Oct 31, 2026, 8:10 AM
| Item | Qty | Price | Amount |
|---|---|---|---|
| Composite filling | 1 | $350.00 | $350.00 |