Invoice #1054
Nov 9, 2026, 3:35 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
priya.walsh@example.net
Phone
(630) 555-0135
Payment
Status
Paid
Due
Nov 23, 2026