Template Merge Fields
Template Field Name | Description |
DATE | |
PATIENT_ID | |
PATIENT_FIRST_NAME | |
PATIENT_INITIAL | |
PATIENT_LAST_NAME | |
PATIENT_TITLE | |
ADDRESS_LINE_1 | |
ADDRESS_LINE_2 | |
ADDRESS_LINE_3 | |
ADDRESS_LINE_4 | |
ADDRESS_LINE_5 | |
ADDRESS_LINE_6 | |
TOTALTREATMENTFEE | |
DEPOSIT | |
PREPROC_DISCOUNT | |
PREPROC_AMOUNT | |
INSTALMENTS | |
INTERVAL | |
INS_AMOUNT | |
INS_DATE | |
INS_COMMENT | |
INSTALMENT_AMOUNT | |
FINAL_AMOUNT | |
TOTALFEE | |
PAYMENT_METHOD | |
DEPOSIT_DATE | |
FIRST_DATE | |
LAST_DATE | |
COMMENTS | |
SIGNATURE |