INVOICE
LIKONI CATHOLIC HOSPITAL
P.O BOX 96129-80110,MOMBASA
Phone No: 0703617063
INVOICE NO :
Patient Details
Name :
Patient Number :
INVOICE TO
| Hospital VAT Reg | Tax Date |
|---|---|
| 55353433434 | 2026-08-16 |
| DPT | DATE | QTY | Description | Rate | Amount |
|---|
| Total Due : Ksh 0.00 |
|---|
| Date Paid | Payment Mode | Amount Paid |
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| Total Paid | Ksh: 0 |
| Name : ................................................................ |
| ID NO : ............................................................... |
| Date : .................................................................. |
| Sign and Stamp |
| Name : ................................................................ |
| Approved By : ............................................................... |
| Designation : .................................................................. |
| Date and Stamp |