Edit Payment Details Page Header Name / Inner Page Name

Patient Details

John Doe

PID 681845

Female

25-05-1991

Add New Payment Type

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Social Security

123456789

01-12-2018

31-12-2019

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Company Contract

Facebook

213562

Social Safety Pack

1234567890

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On ‘Save’ the newly added payment type(s) will be listed below in ‘Validate Payment’
Back Save

Validate Payment

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Social Security

123456789

01-12-2018

31-12-2019

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Insurance Insurance (This payment type is not valid for this Apt.)

error

Suftansa Insurance

error

213562

error

Safe Suftansa Pack

01-12-2018

error

31-12-2019

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Ref # from the insurance website
Decline Validate

Company Contract

Facebook

213562

Social Safety Pack

1234567890

Lorem ipsum dolor sit amet, consectetur adipiscing elit, sed do eiusmod tempor incididunt ut labore et dolore magna aliqua.

Decline Validated
Back Save
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