Invoice Doctor General Practitioner in Argentina Córdoba –Free Word Template Download with AI
Medical License No. 12345-C
Address: Av. Colón 1234, Piso 5, Of. 5B
Córdoba Capital, Córdoba, Argentina
Postal Code: X5000ABC
Phone: +54 351 123-4567
Email: [email protected]
INVOICE
Invoice Number: A-2023-00458
Date of Issue: October 24, 2023
Due Date: November 07, 2023
CUIT: 20-12345678-9
Bill To
Patient Name: Maria Elena Fernandez
Address: Calle San Jerónimo 890, Depto 4
City: Córdoba Capital, Córdoba
Country: Argentina
DNI (ID Number): 25.678.901
Insurance Provider: OSDE / Prepaid Plan
Policy Number: 987654321
Group Number: 112233
Medical Services Rendered
| # | Description of Service | Code (CIP) | Qty | Unit Price (ARS) | Total (ARS) |
|---|---|---|---|---|---|
| 1 |
General Practitioner Consultation Comprehensive physical examination and medical history review. Assessment of general health status, vital signs monitoring, and initial diagnosis of respiratory symptoms. |
01.01.01 | 1 | $15.000,00 | $15.000,00 |
| 2 |
Diagnostic Interpretation Analysis and interpretation of laboratory results (Complete Blood Count, Metabolic Panel) and Chest X-Ray imaging provided by external facility in Córdoba. |
02.05.12 | 1 | $8.500,00 | $8.500,00 |
| 3 |
Medical Certificate Issuance Official documentation certifying medical condition and recommended rest period for employment purposes, compliant with local labor regulations in Argentina. |
09.01.05 | 1 | $5.000,00 | $5.000,00 |
| 4 |
Chronic Disease Management Follow-up consultation for hypertension management. Adjustment of pharmacological treatment plan and lifestyle counseling. |
01.02.03 | 1 | $12.000,00 | $12.000,00 |
Payment Instructions
Please remit payment within 14 days of the invoice date. Payments can be made via bank transfer or cash at the clinic located in Córdoba Capital.
Bank Details:
Bank: Banco Nación Argentina
CBU: 0110000000000000000000
Account Holder: Dr. Alejandro M. Rossi
Reference: Invoice A-2023-00458
Terms and Conditions & Legal Compliance
This Invoice document serves as an official record of medical services provided by a licensed Doctor General Practitioner operating within the jurisdiction of Córdoba, Argentina. All services listed above were rendered in accordance with the ethical standards set forth by the Colegio Médico de la Provincia de Córdoba.
The pricing indicated in this invoice is denominated in Argentine Pesos (ARS) and is subject to the current tax regulations established by the Administración Federal de Ingresos Públicos (AFIP). The Value Added Tax (IVA) of 21% has been applied as required by national law for professional medical services not covered entirely by social security or private insurance agreements.
This document is issued electronically in compliance with the "Factura Electrónica" regulations. The authenticity of this invoice can be verified through the AFIP verification system using the provided CUIT and invoice number. The patient acknowledges receipt of this invoice and agrees to the terms of payment outlined herein. Any disputes regarding the charges must be raised within thirty (30) days of the date of issue.
Medical records associated with these services are maintained securely at the clinic in Córdoba and are accessible to the patient upon request, in accordance with the Ley de Protección de Datos Personales (Personal Data Protection Law) of Argentina. This invoice does not constitute a guarantee of medical outcomes but rather a financial statement of care provided.
Authorized Signature
Dr. Alejandro M. Rossi
Doctor General Practitioner
Patient / Guarantor Signature
Acknowledging Receipt
Date: _______________
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