2026/Mar/26 1:50:30 PM 46043985614->555-12142 2/10
Mar 26, 2026 01:45 To; +46045205552 Page: 02/10 From: Foremed Medical Clinic Fax: 16043985614

INVOICE - 315113 Date: Mar 26, 2026 at 1:27 PM

tS

Foremed Clinic

420 Columbia St., New Westminster, BC V3L 1B1
Telephone: 604522 2206

Fax: 604 522 7206

Billing To [Search] Patient ( 9128549738 )

Name: BC Translink - Occupational & Wellness Name: HOLAND., MARK THOMAS

Address: f ; 604-520-5552 Address:
City: 311-318 Agnes st
Province: Her westminster , BC
Postal: Gender: M

Birth Date : 1978-09-04

Bill Details

Bill Details

Date Practiti Payee an Ref. Tv ype Ref. Da ctor Ref. Type

2026-03- Ademiluyi (68199),
14 Gbogboade

DK
Codes

" Total
Unit Fee GST Amount
Employer's Occupational Fitness Assessment - extra
to examination (BCMA Rates) ag4s29 «1.0 © 780 213.00 10.65

315113

Subtotal: 213.00
GST Total: 10.65
Total: 223,65
Payments: 0.00

Please Make Cheque Payable Ta:

F. Kara Holdings. Lower Ltd.

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

Fax: 604-522-7206 rete: 9,00
registration@secure.foremeddinic.com ss Le 223.65

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