ZonaPAGOS.com Pagos
    
 
Please enter the required information for payment of our services and then to click on the SEND button. Then you should select the method of payment on the next screen.
  Id number of the payer *
  Total to be paid *
  Total after taxes (In this field you must enter the number in zero) - *
  Payment reference or bill number *
  Name and last name of the patient *
  Id number of the patient
  E-mail *
  Medical record number
  Name of the person that makes the payment *
  Phone number of the person that makes the payment *
  Email *

 
    
 
 

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