Park Avenue Clinic
1001 Main street
New York, NY 230404
21 September 2025
Transaction with Credit
Full name | Master Card | Visa | Amex | Discovery | Unknown | All Credit Cards | Cash | Check | Total |
|---|---|---|---|---|---|---|---|---|---|
| Empty | - | $55 | - | - | - | Empty | Empty | Empty | Empty |
| Empty | - | $55 | - | - | - | Empty | Empty | Empty | Empty |
| Empty | - | $55 | - | - | - | Empty | Empty | Empty | Empty |
Grand Total:
$555
All Credit Cards:
$5000
Total:
$888
Patient ID | Name | DOB | Provider | Amount | Method | Product | Description | Type | Voucher Name | Date | Memo | Trans. ID | Auth Code |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |
| Empty | - | $55 | - | - | - | - | - | - | Empty | Empty | Empty | $55 | Empty |