Invoice Chemist in New Zealand Wellington –Free Word Template Download with AI
142 Lambton Quay, Te Aro
Wellington 6011, New Zealand
Phone: +64 4 382 5678
Email: [email protected]
Pharmacy Licence No: NZ-PL-2024-08841
Invoice No: WC-2025-04782
Date Issued: 14 June 2025
Due Date: 28 June 2025
PENDING PAYMENT
Billed To
Customer Name: Margaret A. Thompson
Address: 27 Cuba Street, Thorndon
Wellington 6011, New Zealand
Phone: +64 21 456 7890
Email: [email protected]
PHARMBSN No: 8842-3391-0057
Prescribing Physician
Dr. James R. Whitfield
Wellington Community Health Centre
Address: 55 Victoria Street West
Wellington 6011, New Zealand
Medical Practitioner No: 112-4456
Prescription Date: 12 June 2025
| Item No. | Description | Quantity | Unit Price (NZD) | Subtotal (NZD) |
|---|---|---|---|---|
| 01 | Amoxicillin 500mg Capsules – 28-day supply (Prescription Dispensed by Chemist) | 1 | $12.50 | $12.50 |
| 02 | Metformin 850mg Tablets – 90-day supply (Prescription Dispensed by Chemist) | 1 | $8.75 | $8.75 |
| 03 | Atorvastatin 20mg Tablets – 90-day supply (Prescription Dispensed by Chemist) | 1 | $10.20 | $10.20 |
| 04 | Salbutamol Inhaler 100mcg – 200 doses (Prescription Dispensed by Chemist) | 1 | $15.80 | $15.80 |
| 05 | Pharmacist Consultation & Medication Review Service | 1 | $25.00 | $25.00 |
| 06 | Wellness Vitamin C 1000mg Effervescent Tablets – 30 count (OTC Product) | 2 | $14.95 | $29.90 |
| 07 | Sunscreen SPF 50+ – 200ml (Wellington UV Protection Recommendation) | 1 | $22.50 | $22.50 |
| 08 | Pharmacy Dispensing & Packaging Fee (Wellington Chemist Service Charge) | 1 | $5.00 | $5.00 |
| Subtotal | $129.65 |
| PHARMBSN Subsidy (Prescription Items) | -$47.25 |
| GST (15% on OTC Items) | $6.53 |
| Grand Total Due | $88.93 NZD |
Payment Details
Payment Method: EFTPOS / Bank Transfer / PHARMBSN Direct Billing
Bank: ANZ Bank, Wellington Central Branch
Account Name: Wellington Chemist & Pharmacy Ltd
Account Number: 01-0456-7890123-00
Reference: WC-2025-04782
Payment Due: Within 14 days of invoice date (28 June 2025)
Important Notes & Terms of Service
- This invoice has been issued by Wellington Chemist & Pharmacy, a registered pharmacy operating under the Pharmacy Act 1983 of New Zealand. All prescription medications listed above were dispensed in accordance with New Zealand pharmaceutical regulations and the specific prescription provided by the prescribing physician.
- The PHARMBSN subsidy applied to prescription items reflects the standard New Zealand government pharmaceutical benefit scheme. Customers residing in the Wellington region are eligible for subsidised prescription pricing as outlined by the Ministry of Health, New Zealand.
- As a licensed Chemist operating in New Zealand Wellington, our pharmacy is committed to providing the highest standard of pharmaceutical care. All medications dispensed have been verified by a registered pharmacist in compliance with the Pharmacy Council of New Zealand guidelines.
- Over-the-counter (OTC) products are subject to the standard 15% Goods and Services Tax (GST) as mandated by the Inland Revenue Department of New Zealand. Prescription items subsidised under PHARMBSN are exempt from GST.
- Please present this invoice along with your PHARMBSN card at the point of payment. If you have any questions regarding your medication, dosage, or the items listed on this invoice, please contact our dispensing Chemist at the Wellington location during business hours (Monday to Friday, 8:30 AM – 6:00 PM; Saturday, 9:00 AM – 1:00 PM).
- Late payments exceeding the 14-day payment window may incur a late fee of 2% per month as per New Zealand commercial invoicing standards. Please contact our billing department immediately if you experience any difficulty settling this invoice.
- Wellington Chemist & Pharmacy participates in the New Zealand community pharmacy network. This invoice may be submitted to your health insurer or employer's health benefit scheme for reimbursement of any out-of-pocket expenses not covered by PHARMBSN.
- All customer data contained in this invoice is protected under the Privacy Act 2020 of New Zealand. Your personal and medical information will not be disclosed to third parties without your explicit written consent, in accordance with New Zealand data protection legislation.
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