Invoice Doctor General Practitioner in Iraq Baghdad –Free Word Template Download with AI
Al-Karrada District, Baghdad, Iraq
Phone: +964 770 123 4567
Email: [email protected]
Ministry of Health License No: BAG-2023-8891
Invoice No: INV-2023-10-045
Date: October 24, 2023
Due Date: October 31, 2023
Bill To (Patient)
Name: Ahmed Hassan Ali
National ID: 10823456789
Address: Street 45, Mansour District, Baghdad, Iraq
Phone: +964 780 987 6543
Insurance Provider: Al-Mustaqbal Health Insurance
Policy Number: INS-IQ-998877
Service Provider
Doctor: Dr. Layla Karim
Specialty: Doctor General Practitioner
Medical Council ID: MC-IQ-5543
Clinic Location: Baghdad, Iraq
Tax ID: VAT-IQ-2023-112233
This document serves as an official Invoice for medical services rendered by a qualified Doctor General Practitioner located in Iraq Baghdad. The services detailed below were provided in accordance with the medical standards set by the Iraqi Ministry of Health. This invoice is valid for reimbursement purposes by insurance companies operating within Iraq and for personal financial records.
| # | Description of Service | Date | Quantity | Unit Price (IQD) | Total (IQD) |
|---|---|---|---|---|---|
| 1 |
Initial Consultation - Doctor General Practitioner Comprehensive physical examination and medical history review conducted in Baghdad clinic. |
Oct 24, 2023 | 1 | 25,000 | 25,000 |
| 2 |
Diagnostic Assessment Evaluation of symptoms including blood pressure monitoring and basic vitals check. |
Oct 24, 2023 | 1 | 15,000 | 15,000 |
| 3 |
Prescription Issuance Official medical prescription for medication as required by Iraqi law. |
Oct 24, 2023 | 1 | 5,000 | 5,000 |
| 4 |
Referral Letter Referral to specialist if needed within Baghdad medical network. |
Oct 24, 2023 | 1 | 10,000 | 10,000 |
| 5 |
Follow-up Consultation Scheduled follow-up visit with Doctor General Practitioner. |
Oct 31, 2023 | 1 | 20,000 | 20,000 |
Amount in words: Seventy-Seven Thousand Two Hundred Fifty Iraqi Dinars Only.
Payment Instructions
Payment for this Invoice can be made via cash, bank transfer, or insurance direct billing. For bank transfers, please use the following details:
- Bank Name: Rafidain Bank, Baghdad Branch
- Account Name: Al-Rafidain Medical Center
- Account Number: 1234567890123456
- IBAN: IQ98 RAFI 0000 1234 5678 9012
Please reference the Invoice Number when making payment. Late payments may incur a penalty as per Iraqi commercial law.
Terms and Conditions
- This Invoice is issued by a licensed Doctor General Practitioner operating in Iraq Baghdad.
- All services are subject to the regulations of the Iraqi Ministry of Health.
- Payment is due within 7 days from the date of this invoice.
- Insurance claims must be submitted with this original invoice and supporting medical documents.
- Any disputes regarding this invoice should be resolved through the Baghdad Medical Syndicate.
Doctor General Practitioner
Dr. Layla Karim
Signature & Stamp
Patient / Authorized Representative
Ahmed Hassan Ali
Signature
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