Invoice Dentist in Thailand Bangkok –Free Word Template Download with AI
123 Sukhumvit Road, Khlong Toei Nuea
Watthana District, Bangkok 10110, Thailand
Tel: +66 2 123 4567 | Email: [email protected]
VAT Registration No.: 0105555555555
Date: October 24, 2023
Due Date: November 24, 2023
Bill To:
Mr. John Smith
456 Silom Road, Bang Rak
Bangkok 10500, Thailand
Email: [email protected]
Phone: +66 89 123 4567
| # | Description of Dental Services | Code | Unit Price (THB) | Total (THB) |
|---|---|---|---|---|
| 1 |
Initial Comprehensive Consultation Includes full oral examination, digital panoramic X-rays, and treatment planning session with the lead dentist at our Bangkok clinic. |
DC-001 | 2,500.00 | 2,500.00 |
| 2 |
Professional Dental Cleaning (Scaling & Polishing) Ultrasonic scaling to remove tartar and plaque buildup, followed by manual polishing to ensure a smooth enamel surface. |
DC-002 | 1,500.00 | 1,500.00 |
| 3 |
Composite Resin Fillings (Upper Anterior) Restoration of tooth #11 and #21 using high-quality aesthetic composite material to match natural tooth shade. |
DC-003 | 3,500.00 | 7,000.00 |
| 4 |
Root Canal Therapy (Molar) Endodontic treatment for tooth #36 including local anesthesia, canal shaping, cleaning, and obturation. |
DC-004 | 12,000.00 | 12,000.00 |
| 5 |
Zirconia Dental Crown Custom-fabricated zirconia crown for tooth #36 to restore structural integrity and aesthetics. Includes impression and temporary crown. |
DC-005 | 15,000.00 | 15,000.00 |
| 6 |
Teeth Whitening (In-Office Zoom) Professional bleaching treatment using LED light activation for immediate whitening results. |
DC-006 | 8,000.00 | 8,000.00 |
| 7 |
Follow-up Examination Post-treatment check-up to ensure healing progress and crown fitment verification. |
DC-007 | 1,000.00 | 1,000.00 |
Payment Instructions:
Please remit payment within 30 days of the invoice date. We accept bank transfers, credit cards, and cash at our Bangkok clinic.
Bank Transfer Details:
Bank: Bangkok Bank
Branch: Sukhumvit 21
Account Name: Bangkok Elite Dental Clinic Co., Ltd.
Account Number: 123-4-56789-0
Terms and Conditions:
1. This invoice is issued in accordance with the Revenue Code of Thailand. All prices are quoted in Thai Baht (THB).
2. Late payments may incur a penalty fee of 1.5% per month on the outstanding balance.
3. Please quote the Invoice Number (INV-BKK-2023-0892) when making payment.
4. If you have any questions regarding this invoice or your dental treatment, please contact our billing department at +66 2 123 4567.
5. Warranty on dental crowns and restorations is valid for 12 months from the date of completion, subject to regular maintenance.
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