Tax Invoice

Address: 15 Hodges Mews, High Wycombe HP12 3JL, United Kingdom.
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Dreams Medical

Patient Information
Patient Name : Micle Richard
Patient Birth Date :32 Years Old - 22 July 1991
Insurence Billed :WPS
Patient No :123456789
Service : Dental Treatment
Due Date : 25 Dec 2022
Address : 4 Balmy Beach Road, Owen Sound, Ontario, Canada
# Item Rate/Item Qty Amount
1 Dental Treatment $100 1 $100
2 Bed Charge $100 1 $100
3 Consultant Surgeon Fee $100 1 $100
4 Nursing Service Charge $100 1 $100
5 Medical Hospital Supply $100 1 $100
6 Dental Treatment $100 1 $100
Taxable Amount $600.00
IGST 18.0% $6.00
Total Items / Qty : 6 / 6.00
Total Amount $606.00

Total amount ( in words): INR Six Hundred Six Dollers Only.

Payment Info:
Debit Card : 465 *************645
Amount : $1,815
Terms & Conditions:
  1. Goods Once sold cannot be taken back or exchanged
  2. We are not the manufactures, company will stand for warrenty as per their terms and conditions.
Thanks for your Business
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