Invoice Dentist in India New Delhi –Free Word Template Download with AI
123, Connaught Place, New Delhi - 110001, India
Phone: +91-11-2345-6789 | Email: [email protected]
GSTIN: 07AABCS1234F1Z5
Registration No: DL/DENT/2015/12345
Invoice No: INV/2024/0892
Date: 15th March 2024
Due Date: 30th March 2024
Payment Status: Pending
Billed To:
Patient Name: Rajesh Kumar Sharma
Address: 45, Green Park Extension, New Delhi - 110016, India
Phone: +91-98765-43210
Email: [email protected]
Patient ID: SC/2024/1234
GST Compliance Notice: This invoice is issued in accordance with the Goods and Services Tax (GST) Act, 2017, applicable in India. Dental services are subject to GST at the rate of 18% as per current regulations in New Delhi and across India. All amounts mentioned are inclusive of applicable taxes unless otherwise specified.
| S.No | Description of Dental Services | HSN/SAC Code | Qty | Unit Price (₹) | Amount (₹) |
|---|---|---|---|---|---|
| 1 | Comprehensive Dental Examination and Consultation with Digital X-Ray Imaging | 999511 | 1 | 1,500.00 | 1,500.00 |
| 2 | Professional Teeth Cleaning (Scaling and Polishing) - Full Mouth | 999511 | 1 | 3,000.00 | 3,000.00 |
| 3 | Root Canal Treatment (RCT) - Single Root Tooth with Post and Core | 999511 | 1 | 8,500.00 | 8,500.00 |
| 4 | Ceramic Dental Crown - Zirconia Material with Cementation | 999511 | 1 | 12,000.00 | 12,000.00 |
| 5 | Composite Filling - Aesthetic Tooth-Colored Restoration (2 Surfaces) | 999511 | 2 | 2,500.00 | 5,000.00 |
| 6 | Local Anesthesia and Pain Management Medication | 999511 | 1 | 500.00 | 500.00 |
| 7 | Follow-up Consultation and Post-Treatment Care Assessment | 999511 | 1 | 800.00 | 800.00 |
| 8 | Dental Impression and Study Models for Treatment Planning | 999511 | 1 | 1,200.00 | 1,200.00 |
Amount in words: Thirty-Seven Thousand Eight Hundred Fifty Rupees Only
Terms and Conditions:
1. Payment is due within 15 days from the date of this invoice. Late payments may attract interest at 1.5% per month.
2. This invoice is valid for tax deduction purposes under the Income Tax Act, 1961, India.
3. All dental treatments have been performed by qualified dentists registered with the Dental Council of India.
4. Warranty on dental crowns and restorations is valid for 12 months from the date of completion.
5. In case of any discrepancy in this invoice, please contact our billing department within 7 days.
6. This invoice is computer-generated and does not require a physical signature to be valid.
7. GST is applicable as per the prevailing rates in India New Delhi. Any changes in tax rates will be reflected in future invoices.
8. For insurance claims, please submit this original invoice along with the treatment summary and prescription.
Authorized Signatory
Dr. Priya Mehta
Lead Dentist & Clinic Director
SmileCare Dental Clinic, New Delhi
Patient Acknowledgment
Signature: _________________
Date: _________________
Thank you for choosing SmileCare Dental Clinic in New Delhi, India. We are committed to providing you with the highest quality dental care and maintaining transparent billing practices in compliance with Indian regulations.
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT