Invoice Doctor General Practitioner in Thailand Bangkok –Free Word Template Download with AI
123 Sukhumvit Road, Khlong Toei Nuea
Watthana District, Bangkok 10110
Thailand
Tel: +66 2 123 4567
Email: [email protected]
VAT ID: 010555900000000
INVOICE
Invoice Number: INV-BKK-2023-00458
Date of Issue: October 24, 2023
Date of Service: October 24, 2023
Due Date: Upon Receipt
Bill To (Patient Details)
Name: Mr. John Doe
Address: 456 Wireless Road, Lumpini, Pathum Wan
Bangkok 10330, Thailand
Phone: +66 89 123 4567
Email: [email protected]
Patient ID: PAT-889210
The following invoice details the medical consultation and treatment provided by a licensed Doctor General Practitioner at our Bangkok facility. All services adhere to the standards set by the Medical Council of Thailand.
| Item | Description of Service | Code | Unit Price (THB) | Total (THB) |
|---|---|---|---|---|
| 1 | Initial Consultation Fee: Comprehensive medical assessment by a Doctor General Practitioner. Includes review of medical history, current symptoms analysis, and preliminary diagnosis. | GP-001 | 1,500.00 | 1,500.00 |
| 2 | Physical Examination: Detailed physical check-up including vital signs monitoring (blood pressure, heart rate, temperature), auscultation of heart and lungs, and abdominal palpation. | GP-002 | 800.00 | 800.00 |
| 3 | Diagnostic Blood Work: Complete Blood Count (CBC) and Basic Metabolic Panel ordered by the General Practitioner to assess overall health status and rule out infection. | LAB-105 | 1,200.00 | 1,200.00 |
| 4 | Prescription Medication: Antibiotics and anti-inflammatory medication prescribed for acute respiratory condition. Includes pharmacist consultation. | PHARM-202 | 650.00 | 650.00 |
| 5 | Medical Certificate: Official sick leave certificate issued by the Doctor General Practitioner for employer submission, valid under Thai labor regulations. | DOC-005 | 300.00 | 300.00 |
| 6 | Follow-up Consultation: Brief review of test results and adjustment of treatment plan by the General Practitioner. | GP-003 | 800.00 | 800.00 |
Payment is expected immediately upon receipt of this invoice. We accept the following payment methods common in Thailand Bangkok:
- Cash: Thai Baht (THB) only at the clinic reception.
- Credit/Debit Card: Visa, Mastercard, JCB accepted.
- Bank Transfer:
Bank: Bangkok Bank
Branch: Lumpini
Account Name: Bangkok Central Medical Clinic Co., Ltd.
Account Number: 123-4-56789-0 - PromptPay: ID Number 010555900000000
- This invoice represents the final cost for services rendered by the Doctor General Practitioner on the date specified.
- All prices are inclusive of service charges but exclusive of Value Added Tax (VAT), which is calculated at the statutory rate of 7% as per Thai Revenue Department regulations.
- Payment must be made within 7 days of the invoice date. Late payments may incur a penalty fee of 1.5% per month.
- Insurance claims: If you have private health insurance, please submit this original invoice along with the detailed medical report to your insurance provider for reimbursement. Our clinic does not bill insurance companies directly unless a corporate agreement is in place.
- For any discrepancies regarding this invoice, please contact our billing department within 30 days.
- This document serves as a valid tax invoice for accounting purposes in Thailand.
Authorized Signature
Dr. Somchai Jirapong
Doctor General Practitioner
License No. 12345
Patient Signature
__________________________
Date: ____________________
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