Cape Hearing Aids Tax Invoice

Claremont Pinelands Seapoint Century City Tableview Goodwood Gardens

21 Cavendish St 14a Howard Ctr Artem Centre Colleseum Bldg 125 Blaauwberg Rd G11 Medical Chambers Gardens Centre
Claremont Howard Drive Main Road Century Blvd Tableview Louwtjie Rothman Mill Street
7708 7405 8005 7441 7441 7460 8001
021 671 9293 021 531 6844 021 434 5601 0215517015 021 556 4236 021 595 0220 021 461 8222
Audiologist / Vera Banking Details
Rep: No: INV0021707
Standard Bank
Vat No: 4520103781
Claremont Date: 2021-02-01
Email Address: accounts@capehearingaids.co.za Branch: 025 109
Practice No: Acc: 072527218 Page: 1/1
8300666

Address: Mohamed, Mrs Hajira Patient:

131 Cornflower Street Date of Birth: 0001-01-01
Bridgetown Identity No: 6.41E+12
Medical Aid: Private
Med Aid No:
7764 Ref Doctor: Dr Stulinski

Description Quantity Incl. Price Disc % VAT % Excl Total Incl Total
Sta Receiver 50/60db - Starkey Receiver 50/60dB 1 R 1,100.00 0.00% 15.00% R 956.52 R 1,100.00

Please note: Total Exclusive: R 956.52

While Cape Hearing Aids undertakes to submit this account to your Medical Aid Total VAT: R 143.48
for payment, the account remains the responsibility of the patient. Any shortfall
in payment will be for the patient's account and payable within 30 days of Sub Total: R 1,100.00
inovoice. It is recommended that you follow up with your medical aid or with
Cape Hearing Aids Accounts department to ensure that the account is this Total Rounding: R 0.00
account has been successfully processed.
Total: R 1,100.00