INVOICE - 331566

Foremed Clinic

420 Columbia St., New Westminster, BC V3L 1B1
Telephone: 604 522 2206

Fax: 604 522 7206

Billing To [Search]
Name: Canada Life
Address:

City:

Province:

Postal:

Bill Details

Date Practitioner Payee Ref. Doctor

1:
2026-06- Ademiluyi (68199),
07 Gbogboade

Line# Description
331566 Review fee per 15 min (for medical/legal purposes or
transfer of patient records)
331567 Copy fee per page, to 10 pg A00096a
331568 Copy fee per page, >10 pg A00096b

Please Make Cheque Payable To:

F. Kara Holdings Lower Ltd.

420 Columbia Street, New Westminster, BC, V3L 2X2
Telephone: 604-522-2206

Fax: 604-522-7206
registration@secure.foremedclinic.com

Billing Notes:

Prepayment Required..cr
Ref. no, 130684485

Date: Jun 7, 2026 at 8:49 PM

Patient ( 9128549738 )

Name: HOLAND , MARK THOMAS
Address:

311-318 Agnes st

New Westminster , BC

V3L0J3

Gender: M

Birth Date : 1978-09-04

Ref. Type Ref.Doctor Ref. Type
A: 2: 2:

DX Unit Fee Total Amount

150.00 7.50 157.50

2.10 1.05 22.05
0.36 0.49 10.21

Subtotal: 180.72
GST Total: 9.04
Total: 189.76
Payments: 0.00
Refunds: 0.00

Balance ateyamay