Invoice Midwife in Bangladesh Dhaka –Free Word Template Download with AI

Bill To:

Mr. Rafiqul Islam

House #15, Road #5, Dhanmondi

Dhaka 1205, Bangladesh

NID: 1234567890

Phone: +880 1811-998877

Patient Details:

Name: Mrs. Fatema Begum

Spouse: Mr. Rafiqul Islam

Expected Delivery Date: November 15, 2023

Insurance Provider: None (Self-Pay)

Referring Physician: Dr. A.K. Chowdhury, Dhaka Medical College

#	Description of Midwifery Services	Quantity	Unit Price (BDT)	Total (BDT)
1	Comprehensive Antenatal Care Package (Trimester 3) Includes four scheduled prenatal check-ups, fetal heart rate monitoring, blood pressure assessment, urine analysis, and nutritional counseling provided by certified midwives in Dhaka.	1	12,000.00	12,000.00
2	Professional Midwife Attendance at Delivery Continuous labor support, pain management techniques, monitoring of labor progress, and assistance during vaginal delivery at home or designated clinic in Dhaka.	1	25,000.00	25,000.00
3	Postnatal Care for Mother (First 6 Weeks) Includes three home visits by a midwife for wound care, breastfeeding support, mental health screening, and physical recovery assessment.	1	8,500.00	8,500.00
4	Newborn Care Package Immediate newborn assessment, cord care, vitamin K administration, jaundice screening, and guidance on infant hygiene and feeding practices.	1	6,000.00	6,000.00
5	Emergency Transport Coordination Arrangement and coordination of ambulance services to Dhaka Shishu Hospital or Bangabandhu Sheikh Mujib Medical University (BSMMU) if complications arise.	1	3,500.00	3,500.00
6	24/7 Midwife On-Call Service Dedicated phone support and emergency consultation available throughout the pregnancy and postpartum period.	1	4,000.00	4,000.00
7	Medical Supplies Kit Sterile delivery kit, antiseptics, bandages, and essential medications for mother and newborn.	1	2,500.00	2,500.00

Subtotal: 61,500.00 BDT VAT (5%): 3,075.00 BDT Service Charge (5%): 3,075.00 BDT Total Amount Due: 67,650.00 BDT

Important Notes & Terms of Service:

This invoice represents the agreed-upon fees for midwifery services provided in Dhaka, Bangladesh. All services are rendered by licensed midwives registered with the Bangladesh Midwives Council. Payment is due within 14 days of the invoice date. Late payments may incur a 2% monthly interest charge. In case of medical emergencies requiring hospitalization, additional hospital fees will be billed separately. This invoice is valid for tax deduction purposes as per the National Board of Revenue (NBR) guidelines of Bangladesh.

Please retain this document for your records. For any queries regarding this invoice or the services provided, contact our billing department at +880 1711-223344 or visit our office in Banani, Dhaka.

Payment Instructions:

Bank Transfer:

Bank Name: Dutch-Bangla Bank Ltd.

Branch: Banani, Dhaka

Account Name: Dhaka Maternal Care & Midwifery Services Ltd.

Account Number: 0123456789012

Routing Number: 012345

bKash/Nagad: +880 1711-223344 (Merchant Account)

Please include Invoice Number INV-DH-2023-0892 in the payment reference.

Authorized Signature

Dr. Nusrat Jahan
Chief Midwife & Director
Dhaka Maternal Care

Client Acknowledgment

Mr. Rafiqul Islam
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX

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