Invoice Doctor General Practitioner in United Arab Emirates Abu Dhabi –Free Word Template Download with AI
Doctor General Practitioner Services
License No: DHA-ABU-12345678
TRN: 100.234.567.8910.000
Al Reem Island, Tower B, Office 405
Abu Dhabi, United Arab Emirates
Tel: +971 2 123 4567 | Email: [email protected]
Invoice No: INV-2023-8901
Date: October 24, 2023
Due Date: November 24, 2023
Bill To:
Mr. Ahmed Al Mansoori
Emirates ID: 784-1990-1234567-8
P.O. Box 54321
Mohammed Bin Zayed City
Abu Dhabi, United Arab Emirates
Mobile: +971 50 123 4567
Insurance / Payment Details:
Insurance Provider: Daman Healthcare
Policy Number: DAM-987654321
Group Number: GRP-45678
Pre-Auth Number: PA-2023-5566
Payment Method: Insurance Claim / Direct Billing
Value Added Tax (VAT) Notice: In accordance with the Federal Decree-Law No. (8) of 2017 on Value Added Tax in the United Arab Emirates, a VAT rate of 5% is applied to taxable medical services provided by this Doctor General Practitioner. This invoice serves as a valid tax document for reimbursement and accounting purposes within Abu Dhabi and the wider UAE.| # | Description of Medical Services | Date of Service | Qty | Unit Price (AED) | Total (AED) |
|---|---|---|---|---|---|
| 1 |
General Practitioner Consultation Comprehensive initial assessment by a licensed Doctor General Practitioner in Abu Dhabi. Includes history taking, physical examination, and preliminary diagnosis. |
Oct 24, 2023 | 1 | 350.00 | 350.00 |
| 2 |
Follow-up Consultation Review of previous medical records and assessment of patient progress. Provided by the attending Doctor General Practitioner. |
Oct 24, 2023 | 1 | 250.00 | 250.00 |
| 3 |
Diagnostic Blood Work Panel Full Blood Count (FBC), Lipid Profile, and Liver Function Tests ordered by the General Practitioner. |
Oct 24, 2023 | 1 | 450.00 | 450.00 |
| 4 |
Electrocardiogram (ECG) Standard 12-lead ECG performed and interpreted by the Doctor General Practitioner to assess cardiac health. |
Oct 24, 2023 | 1 | 200.00 | 200.00 |
| 5 |
Medical Certificate Issuance Official medical certificate for employment or personal use, signed and stamped by the Doctor General Practitioner in Abu Dhabi. |
Oct 24, 2023 | 1 | 100.00 | 100.00 |
| 6 |
Prescription Management Electronic prescription submission to UAE Ministry of Health and Prevention (MOHAP) system. |
Oct 24, 2023 | 1 | 50.00 | 50.00 |
Terms and Conditions:
1. This invoice is issued by a licensed Doctor General Practitioner operating under the regulations of the Department of Health – Abu Dhabi (DoH).
2. Payment is due within 30 days of the invoice date. Late payments may incur a penalty as per UAE commercial law.
3. Insurance claims are subject to approval by the respective insurance provider. The patient is responsible for any non-covered amounts.
4. All medical services provided adhere to the highest standards of care in the United Arab Emirates Abu Dhabi healthcare sector.
5. For disputes or queries regarding this invoice, please contact our billing department within 14 days.
6. This document is a valid tax invoice for VAT purposes in the UAE.
Payment Instructions:
Bank Name: Emirates NBD
Account Name: Abu Dhabi General Health Clinic
IBAN: AE07 0331 2345 6789 0123 456
Reference: INV-2023-8901
Authorized Signature
Dr. Sarah Johnson, MD
Doctor General Practitioner
License No: DHA-987654
Patient Acknowledgment
Signature:
Date:
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