Invoice Doctor General Practitioner in Bangladesh Dhaka –Free Word Template Download with AI

Specialization: Doctor General Practitioner
Address: House #12, Road #5, Dhanmondi R/A,
Dhaka-1205, Bangladesh
Phone: +880 2-9123456 | +880 1711-223344
Email: [email protected]
BNB Registration: BNB/2023/12345 Invoice #: INV-2023-10-001
Date: October 24, 2023
Due Date: October 24, 2023 (Immediate)
Payment Status: Pending Bill To: Mr. Kamal Hossain
Flat #3A, Green View Apartment
Mirpur-10, Dhaka-1216
Bangladesh
NID: 1234567890
Phone: +880 1811-998877 Insurance / Referral Info: Insurance Provider: None (Self-Pay)
Policy Number: N/A
Referring Doctor: N/A
Patient ID: P-2023-5567 Description of Medical Services Rendered

#	Service Description	Code	Qty	Unit Price (BDT)	Total (BDT)
1	Initial Consultation with Doctor General Practitioner Comprehensive physical examination, medical history review, and diagnosis for acute respiratory infection. Includes vital signs monitoring (BP, Pulse, Temp, SpO2).	GP-001	1	1,500.00	1,500.00
2	Diagnostic Test: Complete Blood Count (CBC) Laboratory analysis to check for infection markers, anemia, and platelet count. Performed at Dhaka City Medical Center Lab.	LAB-005	1	800.00	800.00
3	Diagnostic Test: Chest X-Ray (PA View) Radiological imaging to assess lung condition and rule out pneumonia. Digital imaging included.	RAD-002	1	1,200.00	1,200.00
4	Prescription Medication Dispensing Antibiotics (Amoxicillin 500mg), Antipyretics (Paracetamol), and Cough Syrup. Dispensed from clinic pharmacy.	PHARM-010	1	950.00	950.00
5	Follow-up Consultation Review of test results and adjustment of treatment plan by Doctor General Practitioner.	GP-002	1	1,000.00	1,000.00
6	Medical Certificate Issuance Official sick leave certificate for 3 days for employer submission.	ADM-001	1	300.00	300.00

Subtotal: 5,750.00 BDT VAT (5%): 287.50 BDT Discount (Senior Citizen 5%): -287.50 BDT TOTAL DUE: 5,750.00 BDT Amount in Words: Five Thousand Seven Hundred Fifty Taka Only. Payment Methods Accepted

We accept the following payment methods for this Invoice:

Cash: Payable at the clinic reception in Dhaka.
bKash/Nagad: Send to +880 1711-223344 (Merchant Account).
Bank Transfer:
Bank: BRAC Bank PLC
Branch: Dhanmondi, Dhaka
Account Name: Dhaka City Medical Center
Account No: 123456789012

Terms and Conditions:

This Invoice is valid for 30 days from the date of issue.
Payment is due upon receipt of services unless otherwise agreed.
All medical services provided by the Doctor General Practitioner are subject to standard medical ethics and regulations of Bangladesh.
Test results are confidential and will be shared only with the patient or authorized representative.
In case of any discrepancy, please contact the clinic within 7 days.
Refunds are processed only for unrendered services as per clinic policy.

Note: This document serves as an official receipt for tax and insurance purposes in Bangladesh.

CLINIC STAMP Dr. Rafiqul Islam
Doctor General Practitioner
Dhaka City Medical Center ⬇️ Download as DOCX Edit online as DOCX

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