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Male - 64 year - B +ve

+66 2 123 4567 jackdoe@email.com

Patient Billing Code

GEN

Payment Priority

1 C.C 2 Ins

Invoice 1

Invoice 2

Invoice 3

PROMO CODE

Discount Percentage

Discount Value (฿)

00.00

Payable Amount (฿)

2600.00

Total Payment Received (฿)

3000.00

Remaining Amount (฿)

-400.00

Date*

Deposit By*

Amount*

Payment Mode*

18-02-2020

Sheila Franklin

1500

Cash

20-02-2020

Paul Zimmerman

1500

Cash

Payback Against Advance (฿)

Payment Mode

Amount Paid

Online Uploading (75%)

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24-08-2019, 10:10 AM