SINGLE PATIENT LEDGER
Thomas J. Magnani, D.D.S.
Date: 08/31/2017 Page: 1
Patient Name: Chart Number:AR0002
Billing Type: 1
I
DATE TEETH DESCRIPTION PATENT CHARGE PAYMENT BALANCE
06/30/2017 0.00 0.00
07/10/2017 600.00 600.00
07/12/2017 750.00 1350.00
07/12/2017 750.00 2100.00
07/12/2017 650.00 2750.00
07/12/2017 650.00 3400.00
07/12/2017 0.00 3400.00
07/12/2017 22 525.00 3925.00
07/12/2017 22 2500.00 6425.00
07/12/2017 27 525.00 6950.00
07/14/2017 0.00 6950.00
07/20/2017 0.00 6950.00
07/27/2017 0.00 6950.00
TOTAL PATIENT BALANCE AS OF 08/31/2017: 6950.00
EFTA00316352