Invoice #1052
Nov 9, 2026, 1:50 PM
Summary
Awaiting payment
| Item | Qty | Price | Amount |
|---|---|---|---|
| New patient exam, x-rays and cleaning | 1 | $135.00 | $135.00 |
Total$135.00
Outstanding$135.00
Patient
Name
Email
julia.fischer@example.net
Phone
(630) 555-0117
Payment
Status
Awaiting payment
Due
Nov 23, 2026