Invoice Dentist in India Bangalore –Free Word Template Download with AI
123 MG Road, Indiranagar
Bangalore, Karnataka - 560038
India
Phone: +91 80 1234 5678
Email: [email protected]
GSTIN: 29ABCDE1234F1Z5
Bank Details:
Account Name: SmileCare Dental Clinic
Bank: HDFC Bank
Branch: Indiranagar, Bangalore
Account No: 50100123456789
IFSC Code: HDFC0001234
INVOICEPatient Name: Rajesh Kumar
Address: 456 Koramangala 4th Block
Bangalore, Karnataka - 560034
India
Phone: +91 98765 43210
Email: [email protected]
Invoice Number: INV-2024-00456
Date of Issue: 15th July 2024
Date of Service: 10th July 2024
Due Date: 30th July 2024
Payment Method: UPI / Net Banking / Cash
| S.No | Description of Dental Services | Quantity | Unit Price (INR) | Amount (INR) |
|---|---|---|---|---|
| 1 | Comprehensive Dental Examination and Consultation | 1 | 500.00 | 500.00 |
| 2 | Full Mouth Panoramic X-Ray (OPG) | 1 | 1,200.00 | 1,200.00 |
| 3 | Professional Scaling and Polishing | 1 | 2,500.00 | 2,500.00 |
| 4 | Root Canal Treatment (RCT) - Molar Tooth | 1 | 8,000.00 | 8,000.00 |
| 5 | Porcelain Crown Fabrication and Placement | 1 | 12,000.00 | 12,000.00 |
| 6 | Composite Filling - Anterior Tooth | 2 | 1,500.00 | 3,000.00 |
| 7 | Prescription Medications (Antibiotics & Painkillers) | 1 | 450.00 | 450.00 |
| 8 | Follow-up Consultation Visit | 1 | 300.00 | 300.00 |
Subtotal: INR 27,950.00
GST @ 18%: INR 5,031.00
Total Amount Due: INR 32,981.00
Terms and Conditions:
1. Payment is due within 15 days from the date of this invoice.
2. Late payments may incur a penalty of 2% per month on the outstanding amount.
3. All dental services provided are subject to the professional judgment of the treating dentist at SmileCare Dental Clinic, Bangalore.
4. This invoice is valid for tax purposes under the Goods and Services Tax (GST) regulations of India.
5. Please quote the invoice number while making any payment or raising queries.
6. In case of any discrepancy in billing, please contact our accounts department within 7 days of receiving this invoice.
7. This document serves as an official record of dental treatment rendered in Bangalore, Karnataka, India.
Authorized Signature
Dr. Priya Sharma
Lead Dentist
SmileCare Dental Clinic, Bangalore
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT