Invoice Chemist in Netherlands Amsterdam –Free Word Template Download with AI
Keizersgracht 427, 1016 GC Amsterdam
The Netherlands
Phone: +31 (0)20 555 0142
Email: [email protected]
KvK: 67894521 | BTW: NL861234567B01
Invoice No: INV-2025-04872
Date: 14 June 2025
Due Date: 28 June 2025
Pending Payment
| # | Description of Item / Service | Product Code | Quantity | Unit Price (EUR) | Total (EUR) |
|---|---|---|---|---|---|
| 1 | Amoxicillin 500mg Capsules (28 capsules) – Antibiotic prescribed for respiratory infection | AMX-500-28 | 1 | € 12.45 | € 12.45 |
| 2 | Metformine 850mg Tablets (60 tablets) – Type 2 Diabetes management | MTF-850-60 | 2 | € 8.90 | € 17.80 |
| 3 | Atorvastatine 20mg Tablets (30 tablets) – Cholesterol management | ATV-20-30 | 1 | € 6.75 | € 6.75 |
| 4 | Salbutamol Inhaler 100mcg (200 doses) – Asthma relief medication | SLB-100-200 | 1 | € 14.20 | € 14.20 |
| 5 | Paracetamol 500mg Tablets (24 tablets) – Over-the-counter pain relief | PCM-500-24 | 2 | € 3.15 | € 6.30 |
| 6 | Pharmaceutical Consultation & Medication Review Service – 30 minutes with licensed pharmacist | SVC-CONS-30 | 1 | € 25.00 | € 25.00 |
| 7 | Home Delivery Service within Amsterdam city centre – Same-day delivery | SVC-DEL-AMS | 1 | € 5.50 | € 5.50 |
| 8 | Vitamin D3 2000 IU Softgels (90 capsules) – Supplement for seasonal wellness | VD3-2000-90 | 1 | € 11.80 | € 11.80 |
| Subtotal | € 99.80 |
| VAT (21% – Standard Rate, Netherlands) | € 20.96 |
| VAT (9% – Reduced Rate on Medications) | € 0.00 |
| Insurance Reimbursement (Zorgverzekeringswet) | - € 42.30 |
| Amount Due | € 78.46 |
Payment Terms & Important Notes
Payment Method: Please settle the outstanding balance of € 78.46 via bank transfer to the IBAN listed below within 14 calendar days from the invoice date. Late payments are subject to a statutory interest rate of 8% per annum in accordance with Dutch civil law (Burgerlijk Wetboek, Book 6, Article 119).
Bank Details: Amsterdam Central Chemist – IBAN: NL21 RABO 0300 0652 14 – BIC: RABONL2A – Reference: INV-2025-04872
Insurance Note: The reimbursement amount of € 42.30 has been deducted in accordance with the basic health insurance (basisverzekering) coverage under the Dutch Zorgverzekeringswet (Zvw). Please retain this invoice for any additional claims to be submitted directly to your health insurance provider (zorgverzekeraar). This chemist in Amsterdam is registered with all major Dutch health insurers including Zilveren Kruis, VGZ, Menzis, CZ, and OHRA.
Medication Disclaimer: All prescription medications dispensed by this chemist in Amsterdam, Netherlands, have been verified against the original prescription issued by Dr. van der Berg. The pharmacist has conducted a full medication review to check for potential drug interactions, allergies, and dosage accuracy. Please contact our pharmacy team immediately if you experience any adverse reactions or have questions regarding your medication regimen.
Return Policy: Unused, unopened prescription medications may be returned to this Amsterdam chemist within 7 days of purchase for a full refund, provided the original packaging and this invoice are presented. Over-the-counter items are subject to standard Dutch consumer return regulations.
Regulatory Compliance: This invoice is issued in compliance with the Dutch Medicines Act (Geneesmiddelenwet) and the regulations of the Dutch Association of Pharmacists (KNMP). Amsterdam Central Chemist operates under a valid pharmacy licence issued by the Municipal Health Service (Gemeentelijke Gezondheidsdienst) of Amsterdam, The Netherlands.
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