Invoice Doctor General Practitioner in Peru Lima –Free Word Template Download with AI
Av. Javier Prado Este 4500, Oficina 302
San Isidro, Lima, Peru
RUC: 20601234567
Phone: +51 1 456 7890
Email: [email protected]
INVOICE
Invoice Number: E-001-045892
Date of Issue: October 24, 2023
Due Date: October 24, 2023 (Immediate Payment)
Payment Method: Credit Card / Yape / Plin
BILL TOClient Name: Maria Elena Rodriguez Lopez
Document Type: DNI (National Identity Document)
Document Number: 72345678
Address: Jr. de la Unión 123, Miraflores, Lima, Peru
Email: [email protected]
MEDICAL SERVICES RENDERED| # | Description of Service | Quantity | Unit Price (PEN) | Total (PEN) |
|---|---|---|---|---|
| 1 | General Practitioner Consultation: Comprehensive clinical evaluation performed by Dr. Alejandro Vargas. Includes patient history taking, physical examination, and preliminary diagnosis. This service adheres to the standards of the Ministry of Health of Peru. | 1 | 150.00 | 150.00 |
| 2 | Diagnostic Interpretation: Professional review and interpretation of recent blood work and imaging results provided by the patient. Detailed explanation of findings regarding metabolic health markers. | 1 | 80.00 | 80.00 |
| 3 | Medical Prescription: Issuance of formal medical prescription for pharmacological treatment and dietary recommendations. Includes electronic signature valid within Peru. | 1 | 20.00 | 20.00 |
| 4 | Medical Certificate: Official medical certificate stating fitness for work or specific medical condition, as requested by the patient for administrative purposes in Lima. | 1 | 40.00 | 40.00 |
| Subtotal: | S/ 290.00 |
| IGV (18% VAT): | S/ 52.20 |
| TOTAL (PEN): | S/ 342.20 |
Please make the payment of S/ 342.20 (Three Hundred Forty-Two Soles and Twenty Cents) via the following methods accepted in Lima, Peru:
- Banco de la Nación: Account No. 123-456789-0-12 (Current Account)
- BCP (Banco de Crédito del Perú): Account No. 987-654321-0-98
- Digital Wallets: Yape / Plin to number +51 987 654 321
Please reference the Invoice Number E-001-045892 in the transfer description.
Legal Notice: This Invoice is issued in accordance with the regulations of the Superintendencia Nacional de Aduanas y de Administración Tributaria (SUNAT) of Peru. This document serves as a valid fiscal receipt for tax deduction purposes. The services provided by this Doctor General Practitioner are governed by the Code of Medical Ethics of Peru.
Privacy Policy: Patient data contained in this invoice is protected under the Law on the Protection of Personal Data (Law No. 29733) of Peru. Information will be used solely for administrative, fiscal, and medical record-keeping purposes.
Validity: This invoice is valid for payment within the territory of Peru. For international patients visiting Lima, this document can be used for reimbursement claims with international insurance providers, subject to their specific policies.
Dispute Resolution: Any disputes regarding this invoice or the medical services rendered shall be resolved through the competent courts of Lima, Peru.
Doctor's Signature:
____________________________
Dr. Alejandro Vargas Mendoza
College of Physicians of Peru No. 45678
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