Invoice Dentist in Uzbekistan Tashkent –Free Word Template Download with AI
Professional Dental Care in Uzbekistan
Address: Amir Temur Avenue 45, Yashnobod District
Tashkent, Uzbekistan 100000
Phone: +998 71 123 45 67
Email: [email protected]
VAT ID: UZ-1234567890
Invoice Number: INV-TK-2023-0892
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Payment Status: Pending
Bill To (Patient)Name: Akmal Karimov
Address: Chilonzor District, Street 12, House 5
City: Tashkent, Uzbekistan
Phone: +998 90 987 65 43
Email: [email protected]
Service ProviderLead Dentist: Dr. Dilnoza Rahimova
Specialization: Orthodontics & Prosthodontics
Clinic License: Tashkent Health Ministry #4592
Bank Details:
Bank: Amarkon Bank
Account: 8601 2345 6789 0123
Description of Dental Services Rendered| # | Service Description | Date | Qty | Unit Price (UZS) | Total (UZS) |
|---|---|---|---|---|---|
| 1 |
Comprehensive Dental Examination Initial consultation and panoramic X-ray analysis performed at our Tashkent facility to assess overall oral health status. |
Oct 10, 2023 | 1 | 350,000 | 350,000 |
| 2 |
Professional Teeth Cleaning (Scaling) Ultrasonic scaling and polishing to remove plaque and tartar buildup, ensuring gum health. |
Oct 10, 2023 | 1 | 500,000 | 500,000 |
| 3 |
Root Canal Therapy (Molar) Endodontic treatment for tooth #36. Includes anesthesia, canal cleaning, shaping, and obturation. |
Oct 15, 2023 | 1 | 1,200,000 | 1,200,000 |
| 4 |
Zirconia Dental Crown Custom-fabricated high-strength zirconia crown for aesthetic and functional restoration of the treated molar. |
Oct 20, 2023 | 1 | 2,500,000 | 2,500,000 |
| 5 |
Composite Filling (Anterior) Tooth-colored composite resin filling for tooth #11 to restore structure and appearance. |
Oct 22, 2023 | 1 | 450,000 | 450,000 |
| 6 |
Follow-up Consultation Post-procedure check-up to ensure proper healing and crown fit. |
Oct 24, 2023 | 1 | 150,000 | 150,000 |
Amount in words: Five million six hundred thousand Uzbekistan Sum.
Terms and Conditions:- Payment is due within 14 days of the invoice date.
- Late payments may incur a penalty fee of 2% per month.
- All dental services are performed by licensed professionals in accordance with Uzbekistan Ministry of Health regulations.
- Warranty on dental crowns and implants is valid for 12 months from the date of installation, subject to proper oral hygiene maintenance.
- Please quote the Invoice Number (INV-TK-2023-0892) when making bank transfers.
- For any disputes regarding this invoice, please contact our billing department in Tashkent within 7 days.
Authorized By:
Dr. Dilnoza RahimovaChief Dentist
Received By (Patient):
Akmal KarimovDate: _______________ ⬇️ Download as DOCX Edit online as DOCX
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