Cosmetic / Plastic Surgery Center

1 Rattanathibet Rd., Bangkasor, Mueang Nonthaburi, Nonthaburi, Thailand.

(+66)-917-707-039, [email protected]

Receipt

-------------------------------

Date:

Ref. No.

We have received a payment in your favor and credited the net amount into your account as specified below:

Account Name : ASIA HOSPITAL

Received Thai Baht Amount: THB ***************
Less Processing Fee: THB **************0
Less Other Charge: THB **************0
Net Credited Amount: THB **************0

This is a computer generated advice. No Authorized signature is required.