INVOICE - 334428

Foremed Clinic

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

Fax: 604 522 7206

Billing To [Search]

Name: MARK THOMAS HOLAND
Address: 311-318 Agnes st

City: New Westminster
Province: BC

Postal: \V3L0J3

Bill Details

Date _ Practitioner Payee

2026-06- Ademiluyi (68199),
16 Gbogboade

Lines Description a

Written /Brief Certificate/Form including
school/work time off, medical certificate
for government employment insurance,
334428 | SPARC-BC Parking Application, Handy
Dart & Handy Card Application + WCB &
ICBC Brief letter/note including insurance
note for physiotherapy/massage therapy

A00060

Date: Jul 9, 2026 at 12:29 PM

Patient ( 9128549738 )

Name: HOLAND , MARK THOMAS
Address:

311-318 Agnes st

New Westminster , BC

V3L0J3

Gender: M

Birth Date : 1978-09-04

Ref. Doctor Ref.Type Ref.Doctor Ref. Type
rT : 2 2

oI
I
on Unit Fee oe Amount
52.90 2.65 55,55

2026-06-18

Payment(MASTERCARD) 4075.06.18 ea

(eee eee eee

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

Subtotal: 52.90
GST Total: 2.65

Total: 55.55
Payments: 55.55
Refunds: 0.00
Balance: 0.00