Invoice #1044
Nov 6, 2026, 8:50 AM
Summary
Awaiting payment
| Item | Qty | Price | Amount |
|---|---|---|---|
| Crown | 1 | $1,360.00 | $1,360.00 |
| New patient exam, x-rays and cleaning | 1 | $120.00 | $120.00 |
Total$1,480.00
Outstanding$1,480.00
Patient
Name
Email
rachel.mitchell@example.com
Phone
(630) 555-0131
Payment
Status
Awaiting payment
Due
Nov 20, 2026