Invoice Dentist in China Beijing –Free Word Template Download with AI
Address: No. 88 Jianguomenwai Avenue, Chaoyang District, Beijing, China 100022
Tax ID (Unified Social Credit Code): 91110105MA01XXXXXK
Phone: +86 10 8588 9999
Email: [email protected]
Invoice Number: INV-BJ-2023-10-0045
Date of Issue: October 24, 2023
Due Date: October 31, 2023
Service Period: October 20, 2023 - October 24, 2023
Service Provider (Dentist)
Lead Dentist: Dr. Li Wei, DDS, MSD
License Number: 11010519800101XXXX
Specialization: Prosthodontics & Cosmetic Dentistry
Clinic Registration: Beijing Health Commission Approved Facility
Billed To (Patient)
Name: Mr. Zhang Wei
ID Number: 11010519900515XXXX
Address: Apt 1204, Tower B, Joy City, Haidian District, Beijing, China
Contact: +86 138 0013 8000
Insurance: Beijing Basic Medical Insurance (Card No: 110105XXXX)
| Item | Description of Dental Services | Code | Qty | Unit Price (CNY) | Total (CNY) |
|---|---|---|---|---|---|
| 1 |
Comprehensive Oral Examination & Consultation Includes panoramic X-ray (OPG), intraoral photography, and periodontal charting. Performed by Dr. Li Wei at the Beijing Capital Dental Clinic. |
DX-001 | 1 | 350.00 | 350.00 |
| 2 |
Full Mouth Scaling and Root Planing (Deep Cleaning) Ultrasonic scaling and hand instrumentation to remove calculus and plaque below the gum line. Essential for treating gingivitis in Beijing's high-stress environment. |
HY-005 | 1 | 1,200.00 | 1,200.00 |
| 3 |
Composite Resin Fillings (Tooth #36) Removal of decay and restoration using high-quality aesthetic composite material. Includes local anesthesia and post-operative check. |
RS-012 | 1 | 800.00 | 800.00 |
| 4 |
Professional Teeth Whitening (In-Office) Laser-assisted whitening treatment using premium peroxide gel. Includes pre-treatment sensitivity assessment and take-home maintenance kit. |
WH-003 | 1 | 2,500.00 | 2,500.00 |
| 5 |
Porcelain Veneer Preparation (Tooth #11) Minimal enamel reduction and impression taking for custom veneer fabrication. Digital scan included. |
VN-008 | 1 | 1,500.00 | 1,500.00 |
| 6 |
Emergency Root Canal Therapy (Tooth #46) Endodontic treatment including access, cleaning, shaping, and obturation. Performed under local anesthesia with rubber dam isolation. |
RC-020 | 1 | 3,200.00 | 3,200.00 |
| 7 |
Temporary Crown Placement Fabrication and cementation of provisional crown for tooth #46 while permanent crown is being manufactured. |
CR-004 | 1 | 400.00 | 400.00 |
| 8 |
Post-Treatment Medication & Care Kit Includes antibiotics, pain relievers, desensitizing toothpaste, and soft-bristle toothbrush recommended by the dentist. |
MD-009 | 1 | 250.00 | 250.00 |
Payment Terms & Conditions
Payment is due within 7 days of the invoice date. Accepted payment methods include WeChat Pay, Alipay, UnionPay credit/debit cards, and bank transfer. For bank transfers, please use the following details:
Bank Name: Bank of China, Chaoyang Branch
Account Name: Beijing Capital Dental Clinic Co., Ltd.
Account Number: 6222 0210 0123 4567 890
SWIFT Code: BKCHCNBJ300
Please reference the Invoice Number (INV-BJ-2023-10-0045) when making payments. Late payments may incur a 2% monthly interest charge. This invoice serves as an official receipt for tax purposes in China. A formal VAT invoice (Fapiao) will be issued upon full payment.
Important Dental Care Instructions
As your dentist in Beijing, we recommend avoiding extremely hot or cold foods for 48 hours after root canal therapy. Maintain good oral hygiene by brushing twice daily and flossing regularly. Schedule your next follow-up appointment within 2 weeks.
Official Clinic Stamp(To be affixed here) ⬇️ Download as DOCX Edit online as DOCX
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