Invoice Midwife in DR Congo Kinshasa –Free Word Template Download with AI
Professional Midwifery Services
123 Avenue de la Paix, Gombe
Kinshasa, Democratic Republic of the Congo
Tel: +243 81 234 5678
Email: [email protected]
NIF: 001234567890123
Invoice Number: INV-2024-0892
Date Issued: October 15, 2024
Due Date: October 30, 2024
Payment Terms: Net 15 Days
Billed To:
Client Name: Marie Claire Mukendi
Address: 45 Avenue Kasa-Vubu, Lingwala
City: Kinshasa, DR Congo
Phone: +243 99 876 5432
Insurance Provider: Mutuelle de Santé Kinshasa Plus
Policy Number: MSP-789456123
| # | Description of Midwifery Services | Date | Qty | Unit Price (CDF) | Total (CDF) |
|---|---|---|---|---|---|
| 1 | Initial Prenatal Consultation and Health Assessment in Kinshasa | 2024-09-01 | 1 | 150,000 | 150,000 |
| 2 | Comprehensive Ultrasound Examination (First Trimester) | 2024-09-05 | 1 | 250,000 | 250,000 |
| 3 | Monthly Prenatal Check-ups (4 sessions) - Midwife Monitoring | 2024-09-15 | 4 | 100,000 | 400,000 |
| 4 | Blood Tests and Laboratory Analysis (HIV, Syphilis, Hepatitis B) | 2024-09-20 | 1 | 180,000 | 180,000 |
| 5 | Prenatal Education Classes for Expectant Parents in DR Congo | 2024-10-01 | 1 | 75,000 | 75,000 |
| 6 | Delivery Services - Normal Vaginal Birth Attended by Certified Midwife | 2024-10-10 | 1 | 1,200,000 | 1,200,000 |
| 7 | Postnatal Care for Mother (First Week) - Kinshasa Facility | 2024-10-11 | 1 | 200,000 | 200,000 |
| 8 | Newborn Care Package (Vaccination, Screening, Initial Check-up) | 2024-10-11 | 1 | 300,000 | 300,000 |
| 9 | Emergency Night Shift Coverage Fee (Midwife On-Call) | 2024-10-10 | 1 | 150,000 | 150,000 |
| 10 | Medical Supplies and Consumables Used During Delivery | 2024-10-10 | 1 | 120,000 | 120,000 |
| Subtotal: | 3,025,000 CDF |
| Discount (Insurance Coverage): | -500,000 CDF |
| VAT (16%): | 400,000 CDF |
| Grand Total: | 2,925,000 CDF |
Amount in Words: Two Million Nine Hundred Twenty-Five Thousand Congolese Francs Only
Important Notes and Terms:
1. This invoice is issued in accordance with the healthcare regulations of the Democratic Republic of the Congo.
2. All midwifery services were provided by licensed professionals at our Kinshasa facility.
3. Payment is due within 15 days from the date of invoice issuance.
4. Late payments will incur a penalty of 2% per month on the outstanding balance.
5. Insurance claims should be submitted directly to Mutuelle de Santé Kinshasa Plus with a copy of this invoice.
6. For any questions regarding this invoice, please contact our billing department at +243 81 234 5678.
7. This document serves as an official receipt for tax purposes in DR Congo.
8. All medical records related to these services are maintained at our Kinshasa clinic for a period of 10 years.
Authorized Signature
Dr. Jean-Pierre Mbemba
Chief Midwife & Medical Director
Maternité Espoir de Kinshasa
Client Acknowledgment
Signature: ___________________
Date: ___________________
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