<%@ Page Title="" Language="VB" MasterPageFile="~/HealthCard.master" AutoEventWireup="false" CodeFile="debitOrder.aspx.vb" Inherits="debitOrder" %>

Debit Order Details
Details
Bank Name Account Name
Account Number Account Type
Enabled
   
Debit Order Amount Debit Order Date


| Change debit order details | Cancel debit order |