A1 Hospital

123 Main Street, Cityville, State, 123456

Contact: +1 (555) 123-4567 | Website: www.A1hospital.com

Appointment Line: +1 (555) 000-1234

A1 Hospital

123 Main Street, Cityville, State, 123456

Contact: +1 (555) 123-4567 | Website: www.A1hospital.com

Invoice Details:

Invoice No: INV528
Visit ID: VID12347
Type of Payment Mode: Cash
Date: Jun 02, 2022

Invoice To:

Patient Name: Smith, Jonathan [1002]
Mobile: +1 (555) 789-0123
Address: 456 Oak Avenue, Cityville, State

Invoice : Cash

S.No.Item CodeItem DescQtyGross Amount ($)Discount ($)Patient Share ($)Tax Amount ($)Net Bill ($)
1MED203X-Ray1300.0030.00270.0015.00285.00
Total300.0030.00270.0015.00285.00
Billed By: EMP1100
Status: Unpaid
Net Tax collection: 0.00
Payment Method Used: Cash
Payment Txn number: ZZ789**
Amount in Words: We have received the net amount of $285.00 via cash from the patient
For: A1 Medical Center

Disclaimer: This is a system-generated invoice copy and does not require any seal or signature. In case of any changes in the billed services or amount, the final invoice can be verified using our app. Any excess amount paid in cash or card will be kept in the patient account. For further assistance, contact our support team.

Thank you for visiting our facility. We wish you a healthy life with us.

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