Invoice Doctor General Practitioner in China Beijing –Free Word Template Download with AI
Department of General Practice
No. 88 Chaoyang North Road, Chaoyang District
Beijing, People's Republic of China, 100020
Tel: +86 10 8523 4567 | Email: [email protected]
Unified Social Credit Code: 91110105MA01XXXXXK
Invoice Number: INV-BJ-2024-0892
Date of Issue: October 24, 2024
Date of Service: October 24, 2024
Payment Status: PAID
Patient InformationName: Zhang Wei
ID Number: 11010519850712XXXX
Address: Apt 1204, Tower B, Joy City, Haidian District, Beijing, China
Phone: +86 138 0013 8000
Insurance Provider: Beijing Basic Medical Insurance Fund
Policy Number: BJ-MI-2024-778899
Attending Physician DetailsDoctor Name: Dr. Li Ming
Specialty: Doctor General Practitioner
License Number: 1101101990001234
Clinic Location: Beijing Capital Medical Center, Floor 2, Room 205
Consultation Type: In-Person General Health Assessment
Description of Medical Services Rendered| Item # | Service Description | Code | Qty | Unit Price (CNY) | Total (CNY) |
|---|---|---|---|---|---|
| 1 | Initial Consultation with Doctor General Practitioner - Comprehensive history taking and physical examination in Beijing | GP-001 | 1 | 150.00 | 150.00 |
| 2 | Blood Pressure Monitoring and Cardiovascular Risk Assessment | GP-002 | 1 | 50.00 | 50.00 |
| 3 | Basic Blood Panel Analysis (CBC, Glucose, Lipids) - Processed at Beijing Central Lab | LAB-105 | 1 | 280.00 | 280.00 |
| 4 | Medical Certificate Issuance for Employment or Travel within China | DOC-010 | 1 | 100.00 | 100.00 |
| 5 | Prescription Medication Consultation and Management by General Practitioner | GP-005 | 1 | 80.00 | 80.00 |
| 6 | Health Education and Lifestyle Counseling Session | GP-008 | 1 | 60.00 | 60.00 |
| Subtotal | ¥720.00 |
| Medical Insurance Coverage (Beijing Fund) | -¥432.00 |
| Patient Co-Pay Responsibility | ¥288.00 |
| TOTAL AMOUNT DUE | ¥288.00 |
Important Notes and Terms of Service
This invoice serves as an official financial record for medical services provided by a licensed Doctor General Practitioner at Beijing Capital Medical Center. All services were rendered in accordance with the healthcare regulations of the People's Republic of China and the specific medical standards upheld in Beijing.
Payment Confirmation: The total amount of ¥288.00 (Two Hundred Eighty-Eight Chinese Yuan) has been settled via UnionPay Card ending in 4589 on October 24, 2024. A portion of the cost was covered by the Beijing Basic Medical Insurance Fund as per the patient's eligibility.
Validity: This invoice is valid for reimbursement claims with private insurance providers or corporate health benefits programs. Please retain this document for your records. In the event of any discrepancies regarding the charges or the services provided by the Doctor General Practitioner, please contact our billing department within 30 days of the date of issue.
Privacy: Patient information contained in this invoice is protected under the Personal Information Protection Law (PIPL) of China. Unauthorized disclosure is strictly prohibited.
Authorized Signature:
Li Ming, MD
Doctor General Practitioner
Official Clinic Stamp:
[OFFICIAL RED SEAL OF BEIJING CAPITAL MEDICAL CENTER] ⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
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