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  • Ambulance Invoice

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    trandreels
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    This invoice is from an ambulance company billing a patient for emergency medical services provided. It details a charge of $750 for basic life support and $180 for 12 miles of ambulance transport, for a total amount due of $988 including taxes. The invoice includes the patient and billing information, date of service, description of services, pricing, and payment details.

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    This invoice is from an ambulance company billing a patient for emergency medical services provided. It details a charge of $750 for basic life support and $180 for 12 miles of ambulance transport, for a total amount due of $988 including taxes. The invoice includes the patient and billing information, date of service, description of services, pricing, and payment details.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    9 views1 page

    Ambulance Invoice

    Uploaded by

    trandreels
    This invoice is from an ambulance company billing a patient for emergency medical services provided. It details a charge of $750 for basic life support and $180 for 12 miles of ambulance transport, for a total amount due of $988 including taxes. The invoice includes the patient and billing information, date of service, description of services, pricing, and payment details.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as docx, pdf, or txt
    of 1

    Company / EMS Name AMBULANCE

    Your address line 1


    Your address line 2
    1(123) 456-7899
    info@youremail.com
    INVOICE
    City, State, ZIP www.yourwebsite.com

    Bill To Invoice # Payment Terms Amount Due


    Patient Name e.g., 000000 e.g., Net 30
    $988.00
    Address line 1 Issue Date Due Date
    Address line 2 e.g., 01/01/2025 e.g., 01/30/2025
    City, State, ZIP

    Description Qty / Miles Price / Rate Amount

    Basic Life Support (BLS) 1 $750.00 $750.00

    Mileage 12 miles $15 / mile $180.00

    Payment Method(s): e.g., Credit Card, Check Subtotal $930.00


    Tax $58.00
    Payment Link(s): Misc. -

    Notes: Amount Due $988.00

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