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Preventive Health Checkup Receipt

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Nota: La filigrana viene mostrata solo nell’anteprima. Il file PDF scaricato non avrà la filigrana.

Anteprima dal vivo

HealthyLife Preventive Care Center Your Wellness, Our Priority 221 Wellness Avenue Suite 304 San Diego, CA 92103 (858) 442-9988 www.healthylifeclinic.com contact@healthylifeclinic.com Clinic ID: HPC-789445

Preventive Health Care Receipt Thank you for choosing HealthyLife Preventive Care Center.

Receipts.oilChangeReceipt.customerName:
Rohan Mehta
Doctor Name:
Dr. Natalie Carter, MD
Receipts.oilChangeReceipt.customerAddress1:
45 Garden Residency
Department:
Preventive Medicine
Address Line 2:
Block B
Visit Reason:
Annual Preventive Wellness Visit
Receipts.oilChangeReceipt.customerCityStateZip:
Ahmedabad, Gujarat 380015
Symptoms Reported:
None
Country:
India
Visit Notes:
Routine health evaluation, blood tests, vaccination administered.
Receipts.oilChangeReceipt.customerEmail:
rohan.m@example.com
Receipts.oilChangeReceipt.customerPhone:
+91 98765 44321
Patient ID:
PAT-55621
Receipts.oilChangeReceipt.subtotalLabel$310.00
Receipts.oilChangeReceipt.discountLabel$-10.00
Receipts.oilChangeReceipt.taxLabel$8.50
Receipts.oilChangeReceipt.paymentLabelForTotal$308.50
Receipts.oilChangeReceipt.paymentLabelForTotal
$0.00
Receipts.oilChangeReceipt.paymentMethodCredit Card
Receipts.oilChangeReceipt.cardNumberMasked**** **** **** 5542
Receipts.oilChangeReceipt.cardTypeVisa
Receipts.oilChangeReceipt.entryTypeChip
Receipts.oilChangeReceipt.authorizationCodeAUTH-PHC-88329
Receipts.oilChangeReceipt.transactionIdTXN-PHC-992314
Receipts.oilChangeReceipt.paymentStatusPAID
Receipts.oilChangeReceipt.paymentDateTime11/14/2025 10:42:58 AM PST
Receipts.oilChangeReceipt.referenceNumber88422949114412844B
Receipts.oilChangeReceipt.dateLabel: 11/14/2025 Receipts.oilChangeReceipt.timeLabel: 10:42:58 AM PST

Receipts.oilChangeReceipt.receiptNumber: PHC-2025-88429 Receipts.oilChangeReceipt.qrText: https://www.healthylifeclinic.com/receipt/PHC-2025-88429 For questions call (858) 442-9988 or email contact@healthylifeclinic.com Thank you for prioritizing your health!

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