Payment Plan

Contents

    Template Merge Fields

    Template Field NameDescription
    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
    Updated on 17th January 2021