Invoice Midwife in Ethiopia Addis Ababa –Free Word Template Download with AI
License No: ETH-MID-2023-8842
Address: Bole Sub-City, Woreda 03, House No. 456
Addis Ababa, Ethiopia
Phone: +251 911 234 567
Email: [email protected]
TIN: 1002345678
Invoice Number: INV-2023-10-089
Date Issued: October 24, 2023
Due Date: November 07, 2023
Payment Status: Pending
Bill To:
Ms. Selamawit Bekele
Private Residence
Kazanchis, Addis Ababa
Ethiopia
ID/Passport: 1234567890
Phone: +251 922 987 654
Service Location:
Home Birth Service
Same as Billing Address
Kazanchis, Addis Ababa
Ethiopia
Referring Physician: Dr. Abebe Tadesse
Hospital Affiliation: Black Lion Specialized Hospital
| # | Description of Midwifery Services | Quantity | Unit Price (ETB) | Total (ETB) |
|---|---|---|---|---|
| 1 |
Comprehensive Prenatal Consultation & Assessment Initial risk assessment, fetal heart rate monitoring, blood pressure check, and nutritional counseling provided by certified midwife in Addis Ababa. |
1 | 1,500.00 | 1,500.00 |
| 2 |
Antenatal Care Visits (Package of 4) Regular monitoring during pregnancy including ultrasound coordination, lab test interpretation, and birth planning sessions. |
4 | 800.00 | 3,200.00 |
| 3 |
Professional Midwife Attendance at Birth Full labor support, delivery assistance, and immediate newborn care provided by experienced midwife at client's home in Addis Ababa. |
1 | 8,500.00 | 8,500.00 |
| 4 |
Postnatal Care Package (Mother & Newborn) 7-day postpartum monitoring including breastfeeding support, perineal care, newborn screening, and immunization scheduling. |
1 | 3,000.00 | 3,000.00 |
| 5 |
Emergency Transport Coordination Standby ambulance arrangement and hospital liaison service for potential complications during labor in Addis Ababa area. |
1 | 2,000.00 | 2,000.00 |
| 6 |
Midwifery Supplies & Equipment Kit Sterile delivery kit, newborn care essentials, and maternal hygiene supplies provided during home birth service. |
1 | 1,200.00 | 1,200.00 |
| 7 |
Birth Documentation & Registration Assistance Preparation of birth certificate documentation and assistance with registration at local Woreda office in Addis Ababa. |
1 | 500.00 | 500.00 |
| Subtotal: | 19,900.00 ETB |
| Discount (Early Booking): | -500.00 ETB |
| VAT (15%): | 2,895.00 ETB |
| TOTAL AMOUNT DUE: | 22,295.00 ETB |
Payment Instructions
Currency: Ethiopian Birr (ETB)
Bank Transfer:
Commercial Bank of Ethiopia
Account Name: Addis Maternal Care & Midwifery Services PLC
Account Number: 1000123456789
Branch: Bole Branch, Addis Ababa
Cash Payment: Accepted at our office in Bole, Addis Ababa during business hours (Monday-Saturday, 8:00 AM - 5:00 PM).
Telebirr/CBE Birr: +251 911 234 567
Please include Invoice Number INV-2023-10-089 as payment reference.
Terms & Conditions
1. Payment is due within 14 days of invoice date. Late payments may incur a 2% monthly interest charge.
2. All midwifery services are provided by licensed professionals registered with the Ethiopian Medical & Health Professions Council.
3. In case of medical emergency requiring hospital transfer, additional hospital fees are not included in this invoice.
4. This invoice is valid for services rendered in Addis Ababa, Ethiopia. Travel fees may apply for locations outside the city.
5. Please retain this invoice for your records and for any insurance reimbursement claims.
6. For questions regarding this invoice, please contact our billing department at [email protected] or call +251 911 234 567.
Service Notes
This invoice covers the complete midwifery care package for Ms. Selamawit Bekele, including prenatal care, home birth attendance, and postnatal support. All services were delivered in accordance with the Ethiopian Federal Ministry of Health guidelines for midwifery practice. The midwife attending this case is certified and has over 10 years of experience in maternal and newborn care in Addis Ababa.
We thank you for trusting Addis Maternal Care & Midwifery Services with your family's health. Our commitment is to provide safe, compassionate, and professional care throughout your pregnancy journey.
Authorized Signature
Dr. Hirut Alemayehu
Lead Midwife & Director
Addis Maternal Care & Midwifery Services
Client Acknowledgment
Signature:
Date:
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT