Riverside Family Clinic
220 Riverside Drive
Toronto, ON M6S 4A8
billing@riversideclinic.ca · +1 416 555 0170 · riversideclinic.ca
Registration no.: CPSO 112233
청구서
- 청구서 번호
- RFC-2026-5531
- 발행일
- 2026년 10월 6일
- 지급 기한
- 2026년 10월 20일
- Patient
- Daniel Osei
- Patient ID
- P-20481
- Doctor
- Dr Amara Singh
공급받는자
Daniel Osei
45 Jane Street
Toronto, ON M6S 3Y3
| 품목 | Code | 수량 | 단가 | 금액 |
|---|---|---|---|---|
| Consultation, extended | A007 | 1 | $120.00 | $120.00 |
| Ultrasound, abdominal | J135 | 1 | $180.00 | $180.00 |
| Blood panel, standard | L301 | 1 | $65.00 | $65.00 |
- 소계
- $365.00
- 합계
- $365.00
결제 정보
Pay online at riversideclinic.ca/pay, by e-transfer to billing@riversideclinic.ca, or at reception.
비고
Not covered by OHIP. Insurance claim submitted to Sun Life, claim no. SL-7782931; patient portion shown below.
거래 조건
Payment is due within 14 days of the invoice date.
Thank you for your business.
