Invoice Dentist in Qatar Doha –Free Word Template Download with AI
Al Waab Street, Zone 66
Doha, Qatar
P.O. Box: 23456
Phone: +974 4456 7890
Email: [email protected]
VAT Registration: 12345678900
Invoice Number: INV-2024-0892
Date: January 15, 2024
Due Date: February 15, 2024
Payment Terms: Net 30 Days
Billed To:
Mr. Ahmed Al-Thani
Al Sadd District, Building 45
Doha, Qatar
Phone: +974 3345 6789
Email: [email protected]
Patient ID: PAT-2024-1567
Important Notice for Qatar Residents: This invoice complies with the Qatar Tax Authority regulations. All amounts are inclusive of applicable taxes as per Qatar's Value Added Tax (VAT) law. Please retain this document for your records and insurance claims.
| Description of Dental Services | Procedure Code | Date of Service | Quantity | Unit Price (QAR) | Total (QAR) |
|---|---|---|---|---|---|
| Comprehensive Dental Examination and Consultation | D0150 | January 10, 2024 | 1 | 350.00 | 350.00 |
| Full Mouth Digital X-Rays (Panoramic) | D0330 | January 10, 2024 | 1 | 450.00 | 450.00 |
| Professional Dental Cleaning (Prophylaxis) | D1110 | January 10, 2024 | 1 | 500.00 | 500.00 |
| Composite Filling - Posterior Tooth (Tooth #30) | D2391 | January 12, 2024 | 1 | 850.00 | 850.00 |
| Root Canal Treatment - Single Root (Tooth #8) | D3310 | January 14, 2024 | 1 | 2,500.00 | 2,500.00 |
| Porcelain Crown - Anterior Tooth (Tooth #8) | D2750 | January 14, 2024 | 1 | 3,200.00 | 3,200.00 |
| Local Anesthesia | D9920 | January 12, 2024 | 2 | 150.00 | 300.00 |
| Follow-up Consultation | D0140 | January 15, 2024 | 1 | 200.00 | 200.00 |
Payment Instructions and Important Notes:
Payment Methods Accepted:
- Bank Transfer: Qatar National Bank (QNB), Account: 1234-5678-9012-3456, SWIFT: QNBAAQDA
- Credit/Debit Cards: Visa, Mastercard, American Express
- Cash: Qatari Riyals (QAR) accepted at our Doha clinic
- QPay and Ooredoo PayCash accepted
Insurance Information: This invoice has been processed with your insurance provider, Bupa Qatar. The remaining balance is your responsibility. Please submit this invoice to your insurance company if required for additional claims.
Late Payment Policy: Payments not received by the due date may incur a late fee of 2% per month, in accordance with Qatar's commercial regulations.
Warranty: All dental work performed at Doha Elite Dental Clinic comes with a 12-month warranty on materials and workmanship, excluding normal wear and tear.
Follow-up Care: Please schedule your next dental check-up within 6 months. Regular dental care is essential for maintaining optimal oral health.
Qatar Healthcare Compliance: All procedures performed comply with the standards set by the Ministry of Public Health, Qatar, and the Primary Health Care Corporation (PHCC).
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