Invoice Chemist in Italy Rome –Free Word Template Download with AI
Chemist & Pharmaceutical Dispensary
Via del Corso, 142 – 00186 Roma (RM), Italy
Partita IVA: IT01234567890
Codice Fiscale: 12345678901
Albo Farmacisti di Roma – Reg. n. 4521
Tel: +39 06 4876 5432 | Email: [email protected]
Invoice Details
Supplier (Chemist / Pharmacy)
Farmacia Chimica di Roma S.r.l.
Via del Corso, 142
00186 Roma (RM), Italy
Pharmacist in Charge: Dott.ssa Elena Marchetti
License No. RM-2019-0087
Chamber of Commerce of Rome: REA RM-1234567
Customer (Purchaser)
Signor Marco Bianchi
Via Appia Nuova, 87
00179 Roma (RM), Italy
Codice Fiscale: BIANCM85A01H501Z
SSN (Tessera Sanitaria): TS-9876543210
Prescription Ref: RX-2025-003421
Line Items – Pharmaceutical Products Dispensed
| # | Product Description | ATC Code / EAN | Qty | Unit Price (€) | IVA % | Total (€) |
|---|---|---|---|---|---|---|
| 1 | Amoxicillin 500 mg Capsules – 21 caps (Prescription) | J01CA04 / 8033521001 | 1 | 12.40 | 22% | 15.13 |
| 2 | Ibuprofen 400 mg Tablets – 20 tabs (OTC) | M01AE01 / 8033521002 | 2 | 4.85 | 22% | 11.83 |
| 3 | Omeprazole 20 mg Gastro-resistant Capsules – 28 caps (Prescription) | A02BC01 / 8033521003 | 1 | 9.60 | 22% | 11.71 |
| 4 | Salbutamol 100 mcg Inhaler – 200 doses (Prescription) | R03AC01 / 8033521004 | 1 | 14.20 | 22% | 17.32 |
| 5 | Vitamin D3 1000 IU Softgels – 60 caps (Supplement) | A11CC05 / 8033521005 | 1 | 18.90 | 22% | 23.06 |
| 6 | Hydrocortisone Cream 1% – 30 g tube (OTC) | D07AA01 / 8033521006 | 1 | 6.30 | 22% | 7.69 |
| 7 | Paracetamol 500 mg Effervescent Tablets – 20 tabs (OTC) | N02BE01 / 8033521007 | 1 | 3.20 | 22% | 3.90 |
| 8 | Oral Rehydration Salts (ORS) – 20 sachets (OTC) | A09BB / 8033521008 | 1 | 7.50 | 22% | 9.15 |
| Subtotal (Net Amount) | € 76.95 |
| IVA 22% (Italian VAT) | € 16.93 |
| SSN Co-payment (Ticket) | – € 4.80 |
| GRAND TOTAL DUE | € 89.08 |
Notes & Payment Terms
This invoice is issued by Farmacia Chimica di Roma, a licensed chemist and pharmaceutical dispensary operating in the city of Rome, Italy, in full compliance with the Italian Ministry of Health (Ministero della Salute) regulations and the provisions of Legislative Decree 219/2006 regarding the dispensing of medicinal products. All prescription items listed above were dispensed pursuant to a valid medical prescription issued by a registered physician in the Lazio region. The customer is advised to read the patient information leaflet enclosed with each pharmaceutical product and to contact the chemist at this pharmacy for any queries regarding dosage, interactions, or storage conditions. Payment for this invoice is due immediately upon receipt. Accepted payment methods include: cash, bank card (Visa, Mastercard, American Express), contactless payment, and electronic transfer to the pharmacy's designated IBAN: IT60 X054 2811 1000 0000 123456. This invoice must be retained by the customer for a minimum period of ten (10) years in accordance with Italian tax law (DPR 600/1973). For any disputes or returns of unopened pharmaceutical products, the customer must present this invoice along with the original packaging within seven (7) calendar days of the date of purchase. The chemist reserves the right to refuse dispensing of controlled substances without a valid, current prescription as mandated by Italian pharmacovigilance law.
[ Pharmacist's Stamp & Signature ] [ Customer's Signature ]Legal Disclaimer: Farmacia Chimica di Roma S.r.l. is a registered pharmaceutical establishment (chemist) operating under the jurisdiction of the ASL Roma 1 (Local Health Authority) and the Order of Pharmacists of Rome. This invoice constitutes a fiscal document (documento fiscale) as defined by Italian tax legislation. The dispensing of all medicinal products listed herein is subject to the Italian Medicines Agency (AIFA) regulations and the European Union Directive 2001/83/EC. The chemist assumes no liability for adverse reactions arising from the misuse of dispensed products. Pharmacovigilance reports may be submitted to AIFA or directly to this pharmacy. Data processing is conducted in accordance with Regulation (EU) 2016/679 (GDPR) and the Italian Privacy Code (D.Lgs. 196/2003 as amended by D.Lgs. 101/2018). The data controller is Dott.ssa Elena Marchetti, Pharmacist in Charge. For data subject rights, please contact the pharmacy at the address stated above. This document was generated electronically and is valid without a physical stamp in accordance with Italian electronic invoicing regulations (SdI – Sistema di Interscambio).
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