Invoice Doctor General Practitioner in India Mumbai –Free Word Template Download with AI
MBBS, MD (General Medicine)
Mumbai Medical Council Reg. No: MH-12345
123, Marine Drive, Near Churchgate Station
Mumbai, Maharashtra - 400020
India Mumbai
Phone: +91 22 1234 5678
Email: [email protected]
Invoice No: INV-2024-0045
Date: October 15, 2024
Due Date: October 22, 2024
Patient Name: Mr. Amit Patel
Address: 45, Bandra West, Mumbai, Maharashtra - 400050
Phone: +91 98765 43210
Email: [email protected]
Patient ID: PAT-2024-1234
Insurance Provider: Star Health Insurance
Policy Number: SHI-987654321
Group ID: GRP-MUM-5678
Pre-Auth Number: PA-2024-7890
This Invoice is issued by Dr. Rajesh Sharma, a registered Doctor General Practitioner practicing in India Mumbai, for the medical consultation and related services provided to the above-mentioned patient. The services were rendered at the clinic located in Mumbai, Maharashtra, India, in accordance with the standards set by the National Medical Commission (NMC) and the Maharashtra Medical Council.
As a Doctor General Practitioner in India Mumbai, I provide comprehensive primary healthcare services including diagnosis, treatment, preventive care, and health education. This Invoice reflects the fees for consultation, diagnostic assessments, and prescribed treatments as per the prevailing medical fee structure in Mumbai.
Services Rendered| S.No | Description of Service | Quantity | Unit Price (INR) | Total (INR) |
|---|---|---|---|---|
| 1 | Initial Consultation with Doctor General Practitioner | 1 | 1,500.00 | 1,500.00 |
| 2 | Physical Examination and Vital Signs Monitoring | 1 | 500.00 | 500.00 |
| 3 | Diagnostic Assessment (Blood Pressure, BMI, General Health Check) | 1 | 800.00 | 800.00 |
| 4 | Prescription and Medication Guidance | 1 | 300.00 | 300.00 |
| 5 | Health Education and Lifestyle Counseling | 1 | 400.00 | 400.00 |
| 6 | Follow-up Consultation (Scheduled) | 1 | 1,000.00 | 1,000.00 |
| 7 | Medical Certificate Issuance | 1 | 200.00 | 200.00 |
| 8 | Administrative and Record Keeping Charges | 1 | 100.00 | 100.00 |
| Subtotal: | 4,800.00 | |||
| GST (18%): | 864.00 | |||
| Total Amount Due: | 5,664.00 | |||
1. Payment is due within 7 days from the date of this Invoice.
2. Late payments may incur a penalty of 2% per month on the outstanding amount.
3. Payments can be made via bank transfer, UPI, or cash at the clinic.
4. Insurance claims should be submitted directly by the patient or through the clinic's billing department.
5. This Invoice is valid for medical reimbursement purposes in India Mumbai and complies with local tax regulations.
6. Any disputes regarding this Invoice should be raised within 15 days of receipt.
Account Name: Dr. Rajesh Sharma
Bank Name: State Bank of India
Branch: Churchgate, Mumbai
Account Number: 1234567890123456
IFSC Code: SBIN0001234
UPI ID: dr.rajesh.sharma@upi
GSTIN: 27AABCU9603R1ZM
HSN Code: 999311 (Medical Services)
Tax Rate: 18% GST applicable as per Indian tax laws for medical services in Mumbai.
Authorized Signature
Dr. Rajesh Sharma
Doctor General Practitioner
Patient Acknowledgment
Signature: _______________
Date: _______________
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