another way around i think you can do :
e.g.
def __after_insert_invoice(f, id):
db(db.treatment.id == f.treatment_no).update(status = 'Invoice')
treatment = db(db.treatment.id == f.treatment_no).select().first() 
db(db.registration.id == treatment.registration_no).update(status = 
'Invoice')
registration = db(db.registration.id == 
treatment.registration_no).select().first()
if registration.appointment_no:
db(db.appointment.id == registration.appointment_no).update(status = 
'Invoice')

db.invoice._after_insert.append(__after_insert_invoice)

best regards,
stifan

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