123 Main Street, Cityville, State, 123456
Contact: +1 (555) 123-4567 | Website: www.A1hospital.com
Appointment Line: +1 (555) 000-1234
| S.No. | Invoice # | Invoice Date | Patient Name | Doctor | Gross Amount ($) | Discount ($) | Patient Share ($) | Tax Amount ($) | Net Bill ($) | Invoice Due ($) | Invoice Status | Billed By |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1 | INV2025-001 | 20 July 2025 | John Doe | Dr. Smith | 1200.00 | 200.00 | 90.00 | 0.00 | 910.00 | 0.00 | Paid | EMP1099 |
| 2 | INV529 | Jun 01, 2022 | Smith, Emily [1001] | Dr. John Hardy | 500.00 | 50.00 | 450.00 | 20.00 | 470.00 | 0.00 | Paid | EMP1099 |
| 3 | INV528 | Jun 02, 2022 | Smith, Jonathan [1002] | Dr. Sarah Lee | 300.00 | 30.00 | 270.00 | 15.00 | 285.00 | 285.00 | Unpaid | EMP1100 |
| 4 | INV2025-002 | 19 July 2025 | Maria Garcia | Dr. Michael Johnson | 950.00 | 100.00 | 0.00 | 42.50 | 892.50 | 0.00 | Paid | EMP1101 |
| 5 | INV2025-003 | 18 July 2025 | Robert Wilson | Dr. Lisa Chen | 250.00 | 25.00 | 225.00 | 11.25 | 236.25 | 0.00 | Paid | EMP1102 |
| 6 | INV2025-004 | 17 July 2025 | Jennifer Brown [CHR001] | Dr. David Miller | 280.00 | 230.00 | 50.00 | 0.00 | 50.00 | 0.00 | Paid | EMP1103 |
| 7 | INV2025-005 | 16 July 2025 | Michael Davis | Dr. Amanda Taylor | 500.00 | 50.00 | 90.00 | 22.50 | 472.50 | 472.50 | Unpaid | EMP1104 |
| 8 | INV2025-006 | 15 July 2025 | Sarah Thompson [CRP002] | Dr. Kevin Rodriguez | 520.00 | 60.00 | 0.00 | 23.00 | 483.00 | 0.00 | Paid | EMP1105 |
| 9 | INV2025-007 | 14 July 2025 | Daniel Martinez | Dr. Rachel Green | 600.00 | 50.00 | 550.00 | 27.50 | 577.50 | 577.50 | Unpaid | EMP1106 |
| 10 | INV2025-008 | 13 July 2025 | Lisa Anderson | Dr. Thomas White | 750.00 | 95.00 | 131.00 | 32.75 | 738.75 | 0.00 | Paid | EMP1107 |