INVOICE - 303628 Date: Jul 9, 2026 at 12:02 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 ve :

fut j - gnes s|
City: ? New Westminster New Westminster , BC
Province: BC V3L0)3
Postal: V3L03 Gender: M

Birth Date : 1978-09-04
Bill Details

Date Practitioner Payee Ref. Doctor ce r ae fae —
2026-02- Ademiluyi (68199),
05 Gbogboade
ey Service a Total
Line# Description Code Qiy des UnitFee “Gor Amount

Written /Brief Certificate/Form including
school/work time off, medical certificate
for government employment insurance,
303628 SPARC-BC Parking Application, Handy © AQ0060 1.0 52.90 2.65 55.55
Dart & Handy Card Application + WCB &
ICBC Brief letter/note including insurance
note for physiotherapy/massage therapy
2026-02-05 (
13°31:33.0 55.55)

Payment(MASTERCARD)
Subtotal: 52.90
GST Total: 2.65

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

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