You are on page 1of 1

INVOICE

Invoiced To Payment To
Company: Bank: Invoice No:
Klinik Isyana Medika Bank Central Asia (BCA) 006/NMC-KIM/VI/2022

Phone: Beneficiary Number: Date:


08116312234 7300353660 02 Juni 2022
Address: Beneficiary Name: Term:
Jl. Panglima Denai No. 53 B, Kel. Denai, PT Naraya Karya Sentana 3 Days
Kec. Medan Denai, Kota Medan,
Sumatera Utara, 20371

Message:
Examination on MAY 2022

No Paket Qty Unit Price Discount Unit Price Total

1 RT-PCR H+1 2 IDR 175.000 IDR 350.000

2 Antigen IDR -

3 IDR -

4 IDR -

Total Unpaid IDR 350.000

Three hundred Fifty Thousand

Received by, Approved by,

Customer Signature & Stamp Naraya Medical Center Medan

You might also like