Invoice Dentist in China Shanghai –Free Word Template Download with AI
Unified Social Credit Code: 91310115MA1K3X4Y5Z
Address: No. 1288 Nanjing East Road, Huangpu District, Shanghai, China 200001
Tax Registration No: SH-TAX-2023-889900
Phone: +86 21 6888 9999
Email: [email protected]
| Invoice No: | SH-DENT-2023-10-045 |
| Date of Issue: | October 24, 2023 |
| Due Date: | November 07, 2023 |
| Currency: | CNY (Chinese Yuan) |
Bill To:
Mr. Zhang Wei
Room 1204, Tower B, Jing'an Kerry Center
1515 West Nanjing Road, Jing'an District
Shanghai, China 200040
ID Number: 31010419850101XXXX
Phone: +86 138 0000 1234
Service Location:
Shanghai Elite Dental Clinic
Huangpu District, Shanghai
Treatment Date: October 20, 2023
Attending Dentist: Dr. Li Ming (License No: SH-310115-2010-556)
| # | Description of Dental Services | Code | Qty | Unit Price (CNY) | Total (CNY) |
|---|---|---|---|---|---|
| 1 |
Comprehensive Dental Examination & Consultation Includes full oral health assessment, periodontal charting, and digital panoramic X-ray imaging. Essential for establishing a baseline treatment plan in accordance with Shanghai dental health standards. |
DX-001 | 1 | 350.00 | 350.00 |
| 2 |
Professional Ultrasonic Scaling and Polishing Deep cleaning procedure to remove tartar and plaque buildup. Includes air-flow polishing for stain removal. Performed by certified dental hygienist under supervision. |
CL-005 | 1 | 600.00 | 600.00 |
| 3 |
Composite Resin Filling (Tooth #36) Restoration of molar cavity using high-grade aesthetic composite material. Includes local anesthesia, cavity preparation, and occlusal adjustment. |
RS-012 | 1 | 1,200.00 | 1,200.00 |
| 4 |
Root Canal Treatment (Tooth #11) Endodontic therapy for maxillary central incisor. Includes access opening, canal negotiation, cleaning, shaping, and obturation. Follows international endodontic protocols. |
EN-008 | 1 | 2,800.00 | 2,800.00 |
| 5 |
Zirconia Dental Crown (Tooth #11) Custom-fabricated full-coverage crown using premium zirconia material for superior strength and aesthetics. Includes temporary crown placement and final cementation. |
CR-020 | 1 | 3,500.00 | 3,500.00 |
| 6 |
Follow-up Consultation & Occlusal Check Post-treatment evaluation to ensure proper healing and bite alignment. Includes minor adjustments if necessary. |
FL-002 | 1 | 200.00 | 200.00 |
| Subtotal: | 8,650.00 CNY |
| Value Added Tax (VAT) @ 6%: | 519.00 CNY |
| Insurance Adjustment: | -500.00 CNY |
| TOTAL AMOUNT DUE: | 8,669.00 CNY |
| Amount in words: Eight Thousand Six Hundred Sixty-Nine Chinese Yuan Only | |
Payment Instructions & Banking Details
Please remit payment within 14 days of the invoice date. Payments can be made via bank transfer, Alipay, WeChat Pay, or credit card at our Shanghai clinic.
Bank Name: Bank of China, Shanghai Branch
Account Name: Shanghai Elite Dental Clinic Co., Ltd.
Account Number: 4567 8901 2345 6789
SWIFT Code: BKCHCNBJ300
Reference: Please include Invoice No. SH-DENT-2023-10-045 in your payment reference.
Terms, Conditions & Legal Notice
This invoice is issued in accordance with the tax regulations of the People's Republic of China and the specific healthcare billing standards applicable in Shanghai. All dental services rendered have been performed by licensed professionals registered with the Shanghai Municipal Health Commission.
1. Validity: This invoice is valid for tax deduction purposes upon presentation of the official Chinese VAT invoice (Fapiao), which will be issued separately upon full payment.
2. Warranty: All restorative work, including crowns and fillings, comes with a 12-month warranty against material defects and workmanship, provided regular dental check-ups are maintained.
3. Disputes: Any disputes regarding this invoice shall be resolved through friendly negotiation. If unresolved, disputes shall be submitted to the Shanghai People's Court for litigation.
4. Privacy: Patient information contained in this invoice is confidential and protected under Chinese personal information protection laws.
5. Overdue Payments: Late payments may incur a penalty fee of 0.05% per day on the outstanding balance.
Authorized Signature:
Dr. Li Ming, Chief Dentist
Official CompanyStamp Area
(Red Seal)
Shanghai Elite Dental Clinic Co., Ltd.
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