INVOICE - 322431 Date: Jul 9, 2026 at 12:24 PM

Foremed Clinic

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

Fax: 604 522 7206

Billing To [Search] Patient ( 9128549738 )
Name: MARK THOMAS HOLAND Name: HOLAND , MARK THOMAS
Address: 311-318 Agnes st eve, ;
pe ; - gnes s
mel = a New Westminster , BC
5 V3L033

Postal: V3L0J3 GonderiM
Birth Date : 1978-09-04

Bill Details
Date Practitioner Payee cr Ref. Tyne Ref. Doctor Ref. Tyne
——eaoo==na_ Hq ab 4 a

2026-04- Ademiluyi (68199),
28 Gbogboade
Linet Description oy gry codes Unit Fee 722! amount

Written /Brief Certificate/Form including
school/work time off, medical certificate
for government employment insurance,
322431  SPARC-BC Parking Application, Handy  A00060 1.0 52.90 2.65 55,55
Dart & Handy Card Application + WCB &
ICBC Brief letter/note including insurance
note for physiotherapy/massage therapy
2026-04-28

Payment(MASTERCARD) 4; 007d -

ee ee
Please Make Cheque Payable To: Subtotal: 52:80
F. Kara Holdings Lower Ltd. GST Total: 2.65
420 Columbia Street, New Westminster, BC, V3L 2X2 Total: 55.55
Telephone: 604-522-2206 Payments: 55.55
Fax: 604-522-7206 Refunds: 0.00
registration@secure.foremedclinic.com Balance: 0.00