Invoice Doctor General Practitioner in China Shanghai –Free Word Template Download with AI
1288 Nanjing West Road, Jing'an District
Shanghai, China 200040
Tel: +86 21 6288 9900
Email: [email protected]
Tax ID: 91310106MA1K3X7Y2P
Invoice Number: INV-SH-GP-2023-00458
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Service Location: China Shanghai
Provider InformationDr. Li Wei, MD
Doctor General Practitioner
License No: 310106-2015-GP-8892
Shanghai International Medical Center
Mr. James Anderson
1500 Huaihai Middle Road, Xuhui District
Shanghai, China 200031
ID/Passport No: AB1234567
Email: [email protected]
| # | Description of Services | Date | Quantity | Unit Price (CNY) | Total (CNY) |
|---|---|---|---|---|---|
| 1 |
Initial Consultation - Doctor General Practitioner Comprehensive medical history review and physical examination conducted by Dr. Li Wei. This service includes assessment of general health status, vital signs monitoring, and preliminary diagnosis formulation within the standards of care in China Shanghai. |
Oct 24, 2023 | 1 | 800.00 | 800.00 |
| 2 |
Diagnostic Blood Panel Full blood count (CBC), liver function test, kidney function test, and lipid profile. Samples collected at the clinic and processed at the affiliated Shanghai Central Laboratory. |
Oct 24, 2023 | 1 | 650.00 | 650.00 |
| 3 |
Electrocardiogram (ECG) Standard 12-lead ECG performed to assess cardiac rhythm and electrical activity. Interpreted by the attending Doctor General Practitioner. |
Oct 24, 2023 | 1 | 300.00 | 300.00 |
| 4 |
Prescription Medication Dispensing of prescribed antibiotics and anti-inflammatory medication as per the treatment plan established during the consultation. |
Oct 24, 2023 | 1 | 450.00 | 450.00 |
| 5 |
Follow-up Consultation Review of laboratory results and ECG findings. Adjustment of treatment plan and health advice provided by the Doctor General Practitioner. |
Oct 27, 2023 | 1 | 500.00 | 500.00 |
| 6 |
Medical Certificate Issuance Official medical certificate for work/school purposes, stamped and signed by the licensed Doctor General Practitioner in accordance with Shanghai municipal regulations. |
Oct 27, 2023 | 1 | 200.00 | 200.00 |
Terms and Conditions
1. Payment is due within 30 days of the invoice date. Late payments may incur a 1.5% monthly interest charge.
2. This Invoice is issued in accordance with the financial regulations of the People's Republic of China.
3. All services were rendered by a licensed Doctor General Practitioner at our facility in China Shanghai.
4. Please quote the Invoice Number (INV-SH-GP-2023-00458) when making payment.
5. For insurance claims, please submit this original Invoice along with the detailed medical report.
6. If you have any questions regarding this Invoice, please contact our billing department at +86 21 6288 9900 ext. 102.
Payment Methods
Bank Transfer:
Bank Name: Bank of China, Shanghai Branch
Account Name: Shanghai International Medical Center Co., Ltd.
Account Number: 4528 7612 9900 1234
SWIFT Code: BKCHCNBJ310
Currency: CNY (Chinese Yuan)
Online Payment:
We accept Alipay and WeChat Pay. Please scan the QR code on the official receipt or contact our front desk for digital payment options.
Dr. Li Wei
Doctor General Practitioner Billing Department
Ms. Zhang Min
Finance Manager ⬇️ Download as DOCX Edit online as DOCX
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