Invoice Chemist in Indonesia Jakarta –Free Word Template Download with AI
Jl. Sudirman Kav. 45, Blok C-12
Setiabudi, South Jakarta 12190
Indonesia Jakarta
Tel: +62-21-520-8844 | Email: [email protected]
NPWP: 09.254.781.0-341.000
Billed To
PT Medika Nusantara Healthcare
Attn: Dr. Ratna Wijaya, Procurement Manager
Jl. Gatot Subroto No. 88, Kuningan
South Jakarta 12950, Indonesia Jakarta
Tel: +62-21-255-6710
Email: [email protected]
Shipped To
PT Medika Nusantara Warehouse
Attn: Logistics Department
Jl. TB Simatupang Kav. 15, Cilandak
South Jakarta 12560, Indonesia Jakarta
Delivery Reference: DO-2025-1187
| # | Description | Product Code | Qty | Unit Price (IDR) | Amount (IDR) |
|---|---|---|---|---|---|
| 1 | Amoxicillin 500mg Capsules (24 caps/box) – Licensed pharmaceutical product dispensed by our registered Chemist team | PHR-AMX-500 | 200 | 45,000 | 9,000,000 |
| 2 | Ibuprofen 400mg Tablets (30 tabs/box) – Over-the-counter analgesic supplied by Apotek Sehat Chemist | PHR-IBU-400 | 350 | 28,500 | 9,975,000 |
| 3 | Paracetamol 500mg Syrup 100ml – Pediatric formulation prepared under Chemist supervision | PHR-PCM-SYP | 150 | 32,000 | 4,800,000 |
| 4 | Oral Rehydration Solution (ORS) Sachets (20 sachets/box) – Hydration product for clinical use | PHR-ORS-20 | 100 | 55,000 | 5,500,000 |
| 5 | Metformin HCl 500mg Tablets (60 tabs/box) – Prescription medication verified by licensed Chemist | PHR-MET-500 | 120 | 62,000 | 7,440,000 |
| 6 | Medical Gloves (Nitrile, Medium) – 100 pcs/box, sterile packaging for clinical procedures | MDL-GLV-NIT | 80 | 85,000 | 6,800,000 |
| 7 | Pharmaceutical Compounding Service – Custom preparation of topical ointment per physician's prescription, performed by our senior Chemist | SVC-CMP-001 | 25 | 175,000 | 4,375,000 |
| 8 | Pharmaceutical Consultation & Drug Interaction Review – Professional service provided by our in-house Chemist advisory team | SVC-CON-002 | 10 | 250,000 | 2,500,000 |
| Subtotal | IDR 50,390,000 |
| Discount (Bulk Order – 3%) | - IDR 1,511,700 |
| Net Subtotal | IDR 48,878,300 |
| PPN (VAT) 11% | IDR 5,376,613 |
| Grand Total | IDR 54,254,913 |
Invoice Notes & Terms of Service
This Invoice is issued by Apotek Sehat Chemist, a licensed pharmaceutical retail and wholesale entity operating in Indonesia Jakarta under the supervision of registered pharmacists (Apoteker) and licensed Chemist professionals in accordance with Indonesian Ministry of Health regulations (Kemenkes RI).
- All pharmaceutical products listed in this Invoice have been sourced from authorized distributors and meet BPOM (Badan Pengawas Obat dan Makanan) quality standards. Each batch has been verified by our on-site Chemist before dispatch.
- Payment is due within fourteen (14) calendar days from the Invoice date. Late payments will incur a penalty of 2% per month as stipulated in our master service agreement.
- Payment may be made via bank transfer to: Bank Mandiri, Account No. 137-00-2255889-9, a.n. PT Apotek Sehat Indonesia, Indonesia Jakarta. Please reference Invoice number INV-2025-07-0342 in your transfer memo.
- Prescription medications (Items 1 and 5) are dispensed strictly under the guidance of a licensed Chemist and require valid physician prescriptions on file. No substitution or alteration of prescribed medication is permitted without prior Chemist approval.
- Pharmaceutical compounding services (Item 7) are performed in our dedicated compounding laboratory in Indonesia Jakarta, adhering to GPP (Good Pharmacy Practice) guidelines. All compounded preparations carry a shelf life of 30 days when stored at 2–8°C.
- Goods once delivered are non-returnable unless a manufacturing defect is identified within 7 days of receipt. Any returns must be pre-approved by our quality assurance Chemist team.
- This Invoice is valid for 30 days from the date of issue. After this period, pricing may be subject to revision due to fluctuating pharmaceutical import costs and exchange rate variations.
- For any disputes regarding this Invoice, both parties agree to resolve matters through mediation in Indonesia Jakarta before pursuing legal action in the South Jakarta District Court.
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