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- <!DOCTYPE html>
- <html lang="en">
- <head>
- <meta charset="utf-8">
- <meta http-equiv="X-UA-Compatible" content="IE=edge">
- <meta name="viewport" content="width=device-width, initial-scale=1">
- <meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no">
- <title>Ouch - Invoice PDF</title>
- </head>
- <body>
- <div style="font-family: Arial, Helvetica, sans-serif; width: 700px; margin: auto; border: solid 1px #e0e0e0;">
- <div>
- <h1 style="text-align: center; background: #f3f3f3; margin-top: 0px; padding: 10px 0px;">Invoice</h1>
- <div style="padding: 0px 10px 15px 10px; width: 100%;">
- <div style="width: 350px; float: left;"> <img src="{{asset('/img/ouchlogo.png')}}" alt="" style="width: 120px;">
- </div>
- <div style="width: 350px; float: right; margin-top: -10px;">
- <p style="font-size: 14px;"><b>Invoice ID</b> <span style="width: 60%; float: right; color: #787878;">:
- 0000837</span></p>
- <p style="font-size: 14px;"><b>Invoice Date</b> <span style="width:60%; float: right; color: #787878;">:
- 27-02-2019</span></p>
- </div>
- </div>
- <div style=" border-bottom: solid 3px #393939;"> </div>
- <div style="padding: 0px 10px;">
- <div style="width: 350px; float: left;">
- <h3 style="color: #20a4cc;">Invoice To :</h3>
- <p style="font-size: 14px; color: #787878;">Anju</p>
- <p style="font-size: 14px; color: #787878; word-break: break-all;">anjutai.gomase+66@perennialsys.com</p>
- <p style="font-size: 14px; color: #787878;">+91-9758695899</p>
- </div>
- <div style="width: 350px; float: right;">
- <h3 style="color: #20a4cc;">Appointment Details :</h3>
- <p style="font-size: 14px;"><b>Appointment ID</b> <span style="width: 60%; float: right; color: #787878;">:
- 87958</span></p>
- <p style="font-size: 14px;"><b>Date</b> <span style="width: 60%; float: right; color: #787878;">:
- 28-02-2019</span></p>
- <p style="font-size: 14px;"><b>Clinic Name</b> <span style="width: 60%; float: right; color: #787878;">:
- Mr. Mount Elizabeth Hospital Elizabeth Hospital Elizabeth Hospital</span></p>
- </div>
- </div>
- <div style="border-bottom: solid 1px #c1c1c1;"> </div>
- <div style="padding: 10px;">
- <div style="width: 350px; float: left;">
- <p style="font-size: 14px;"><b>Patient Name</b> <span style="width: 60%; float: right; color: #787878;">:
- Anjutai Gomase Elizabeth Hospital Elizabeth Hospital</span></p>
- </div>
- <div style="width: 350px; float: right;">
- <p style="font-size: 14px;"><b>Doctor Name</b> <span style="width: 60%; float: right; color: #787878;">:
- Dr. Antony Westwood Gardner Westwood Gardner Westwood Gardner</span></p>
- </div>
- </div>
- <div style=" border-bottom: solid 3px #393939;"> </div>
- <div>
- <h3 style="color: #20a4cc; padding-left: 10px; margin-bottom: 0px; margin-top: 10px;">Billing Details :</h3>
- <div>
- <div style="width: 500px; float: left;">
- <p style="border-bottom: solid 1px #c1c1c1; border-top: solid 1px #c1c1c1; line-height: 10px; margin-bottom: 0px; padding: 15px 0px 10px 10px; background: #f3f3f3;"><b>Billing
- Description</b></p>
- </div>
- <div style="width: 200px; float: right;">
- <p style="border-bottom: solid 1px #c1c1c1; border-top: solid 1px #c1c1c1; line-height: 10px; margin-bottom: 0px; padding: 15px 0px 10px 10px; background: #f3f3f3;"><b>Amount</b></p>
- </div>
- </div>
- <div> </div>
- <div>
- <p style="width: 500px; float: left; padding-left: 10px; margin: 0px; line-height: 10px; font-size: 14px; color: #787878;">Shoulder Pain</p>
- <p style="width: 200px; float: right; font-size: 14px; margin: 0px; line-height: 10px; color: #787878;">SGD 21.03</p>
- </div>
- <div> </div>
- <div>
- <p style="width: 500px; float: left; padding-left: 10px; margin: 0px; line-height: 10px; font-size: 14px; color: #787878;">Shoulder Pain</p>
- <p style="width: 200px; float: right; font-size: 14px; margin: 0px; line-height: 10px; color: #787878;">SGD 21.03</p>
- </div>
- <div style="border-bottom: solid 1px #e2e2e2;"> </div>
- <div>
- <div style="width: 500px; text-align: right; float: left;">
- <p style="font-size: 14px; color:#393939; line-height: 10px; margin-bottom: 0px; padding-right: 15px;"><b>Sub Total</b></p>
- <p style="font-size: 14px; color:#393939;line-height: 10px; margin-bottom: 0px; padding-right: 15px;"><b>Total Tax</b></p>
- </div>
- <div style="width: 200px; float: right;">
- <p style="font-size: 14px; line-height: 10px; margin-bottom: 0px; color: #787878;">SGD 33.03</p>
- <p style="font-size: 14px; line-height: 10px; margin-bottom: 0px; color: #787878;">SGD 8.26</p>
- </div>
- </div>
- <div style="border-bottom: solid 1px #e2e2e2;"> </div>
- <div style="background: #f3f3f3; padding-top: 15px;">
- <div style="width: 500px; text-align: right; float: left;">
- <p style="font-size: 14px; color:#393939; line-height: 10px; margin: 0px; padding-right: 15px;"><b>Total Amount</b></p>
- </div>
- <div style="width: 200px; float: right;">
- <p style="font-size: 14px; line-height: 10px; margin: 0px; color: #393939;"><b>SGD 41.29</b></p>
- </div>
- </div>
- </div>
- <div style="border-bottom: solid 3px #393939;"> </div>
- <div>
- <div style="padding: 0px 10px 10px 10px;">
- <h3 style="color: #20a4cc;">Payment Details :</h3>
- <p style="font-size: 14px;">Amount Paid by Patient <span style="width: 190px; float: right; color: #787878;">SGD
- 41.29</span></p>
- <p style="font-size: 14px;">Amount from Insurance <span style="width: 190px; float: right; color: #787878;">SGD
- 0.00</span></p>
- </div>
- </div>
- </div>
- </div>
- </body>
- </html>
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