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Sugod Kapatid Medical Services AMBULANCE

204 Tula-Tula
Raudas Street
1(123) 456-7890
info@SKMS.com
INVOICE
Legazpi City www.SKMS.com

Bill To Invoice # Payment Terms Amount Due


(Relative’s Name) 00001 Cash
₱5,000.00
(Address line 1) Issue Date Due Date
(Address line 2) (01/01/2023) (01/30/2023)
(City, State, ZIP)

Description Qty / Miles Price / Rate Amount

Basic Life Support (BLS) 1 ₱ 4,300.00 ₱ 4,300.00

Mileage 10 km ₱ 70.00 / km ₱ 700.00

Payment Method(s): ___________________ Subtotal ₱ 5,000.00

Payment Link(s): _________________ Misc. -

Notes: Dead on Arrival Amount Due ₱ 5,000.00

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