Invoice

logo-small

Metrica Hospital

If account is not paid within 7 days the credits details supplied as confirmation.

  • www.abcdefghijklmno.com

    www.qrstuvwxyz.com

  • +123 123456789

    +123 123456789

  • 2821 Kensington Road,

    Avondale Estates, GA 30002 USA.

Patient Name : Donald Gardner
Address : B28 University Street US
Phone No : +123 456 7890
Doctor Name : Dr.Helen White
Department : Orthopedic
Invoice No : #1240
Admit Date : 11/07/2020
Discharge Date : 17/07/2020
No Description Qty Amount
1
Pharmacy
7 $300.00
2
CT Scan
1 $200.00
3
laboratory
3 $300.00
4
Medical/Surgical Supplies and Devices
- $5000.00
Sub Total $5800.00
Tax Rate $0.00%
Total $5800.00
Terms And Condition :
  • All accounts are to be paid within 7 days from receipt of invoice.
  • To be paid by cheque or credit card or direct payment online.
  • If account is not paid within 7 days the credits details supplied as confirmation
    of work undertaken will be charged the agreed quoted fee noted above.
Account Manager

Signature


Thank you very much for doing business with us. Thanks !
© 2019 - 2020 Metrica Crafted with by Mannatthemes