{$pagetitle}

{BEGIN top_block}

{$pagetitlelabel invoices add}

{END top_block} {BEGIN above-grid_block}

{BEGIN message_block}

{$message}

{BEGIN message_back_button} {END message_back_button} {BEGIN view_page_button} {END view_page_button} {BEGIN edit_page_button} {END edit_page_button}

{END message_block}

{END above-grid_block} {BEGIN grid_block} {BEGIN cellblock_grid_c3} {END cellblock_grid_c3}

{BEGIN invoice_num_fieldblock}

{BEGIN invoice_num_label}{$label invoices invoice_num }{END invoice_num_label}

{$invoice_num_editcontrol}

{END invoice_num_fieldblock} {BEGIN nrn_pn_fieldblock}

{BEGIN nrn_pn_label}{$label invoices nrn_pn }{END nrn_pn_label}

{$nrn_pn_editcontrol}

{END nrn_pn_fieldblock} {BEGIN patient_fname_fieldblock}

{BEGIN patient_fname_label}{$label invoices patient_fname }{END patient_fname_label}

{$patient_fname_editcontrol}

{END patient_fname_fieldblock} {BEGIN patient_lname_fieldblock}

{BEGIN patient_lname_label}{$label invoices patient_lname }{END patient_lname_label}

{$patient_lname_editcontrol}

{END patient_lname_fieldblock} {BEGIN created_by_fieldblock}

{BEGIN created_by_label}{$label invoices created_by }{END created_by_label}

{$created_by_editcontrol}

{END created_by_fieldblock} {BEGIN comp_logo_fieldblock}

{BEGIN comp_logo_label}{$label invoices comp_logo }{END comp_logo_label}

{$comp_logo_editcontrol}

{END comp_logo_fieldblock} {BEGIN total_fieldblock}

{BEGIN total_label}{$label invoices total }{END total_label}

{$total_editcontrol}

{END total_fieldblock} {BEGIN balance_fieldblock}

{BEGIN balance_label}{$label invoices balance }{END balance_label}

{$balance_editcontrol}

{END balance_fieldblock} {BEGIN doc_address_fieldblock}

{BEGIN doc_address_label}{$label invoices doc_address }{END doc_address_label}

{$doc_address_editcontrol}

{END doc_address_fieldblock} {BEGIN patient_address_fieldblock}

{BEGIN patient_address_label}{$label invoices patient_address }{END patient_address_label}

{$patient_address_editcontrol}

{END patient_address_fieldblock} {BEGIN comp_address_fieldblock}

{BEGIN comp_address_label}{$label invoices comp_address }{END comp_address_label}

{$comp_address_editcontrol}

{END comp_address_fieldblock} {BEGIN comp_email_fieldblock}

{BEGIN comp_email_label}{$label invoices comp_email }{END comp_email_label}

{$comp_email_editcontrol}

{END comp_email_fieldblock} {BEGIN comp_telenum_fieldblock}

{BEGIN comp_telenum_label}{$label invoices comp_telenum }{END comp_telenum_label}

{$comp_telenum_editcontrol}

{END comp_telenum_fieldblock} {BEGIN comp_fax_fieldblock}

{BEGIN comp_fax_label}{$label invoices comp_fax }{END comp_fax_label}

{$comp_fax_editcontrol}

{END comp_fax_fieldblock} {BEGIN comp_name_fieldblock}

{BEGIN comp_name_label}{$label invoices comp_name }{END comp_name_label}

{$comp_name_editcontrol}

{END comp_name_fieldblock} {BEGIN amt_paid_fieldblock}

{BEGIN amt_paid_label}{$label invoices amt_paid }{END amt_paid_label}

{$amt_paid_editcontrol}

{END amt_paid_fieldblock} {BEGIN payment_meth_fieldblock}

{BEGIN payment_meth_label}{$label invoices payment_meth }{END payment_meth_label}

{$payment_meth_editcontrol}

{END payment_meth_fieldblock} {BEGIN patient_email_fieldblock}

{BEGIN patient_email_label}{$label invoices patient_email }{END patient_email_label}

{$patient_email_editcontrol}

{END patient_email_fieldblock} {BEGIN org_fieldblock}

{BEGIN org_label}{$label invoices org }{END org_label}

{$org_editcontrol}

{END org_fieldblock} {BEGIN id_fieldblock}

{BEGIN id_label}{$label invoices id }{END id_label}

{$id_editcontrol}

{END id_fieldblock} {BEGIN sex_fieldblock}

{BEGIN sex_label}{$label invoices sex }{END sex_label}

{$sex_editcontrol}

{END sex_fieldblock} {BEGIN date_fieldblock}

{BEGIN date_label}{$label invoices date }{END date_label}

{$date_editcontrol}

{END date_fieldblock} {BEGIN time_fieldblock}

{BEGIN time_label}{$label invoices time }{END time_label}

{$time_editcontrol}

{END time_fieldblock} {BEGIN status_fieldblock}

{BEGIN status_label}{$label invoices status }{END status_label}

{$status_editcontrol}

{END status_fieldblock} {BEGIN doc_id_fieldblock}

{BEGIN doc_id_label}{$label invoices doc_id }{END doc_id_label}

{$doc_id_editcontrol}

{END doc_id_fieldblock} {BEGIN inv_paid_date_fieldblock}

{BEGIN inv_paid_date_label}{$label invoices inv_paid_date }{END inv_paid_date_label}

{$inv_paid_date_editcontrol}

{END inv_paid_date_fieldblock} {BEGIN inv_paid_time_fieldblock}

{BEGIN inv_paid_time_label}{$label invoices inv_paid_time }{END inv_paid_time_label}

{$inv_paid_time_editcontrol}

{END inv_paid_time_fieldblock}

{END grid_block} {BEGIN below-grid_block}

Save Reset {BEGIN back_button} Back to list {END back_button} {BEGIN cancel_button} Cancel {END cancel_button}

{END below-grid_block}