Invoice #1055
Nov 9, 2026, 5:50 PM
Summary
Paid
| Item | Qty | Price | Amount |
|---|---|---|---|
| New patient exam, x-rays and cleaning | 1 | $110.00 | $110.00 |
Total$110.00
Paid$110.00
Patient
Name
Email
victor.tran@example.net
Phone
(630) 555-0120
Payment
Status
Paid
Due
Nov 23, 2026