Invoice Midwife in Uganda Kampala –Free Word Template Download with AI
Lead Midwife: Sarah Nalubega, RN, RM
Registration: Uganda Nurses and Midwives Council (UNMC) Reg. No. 45921
Address: Plot 45, Kira Road, Nakawa Division
Kampala, Uganda
Phone: +256 700 123 456
Email: [email protected]
Invoice Number: INV-UG-2023-0892
Date Issued: October 24, 2023
Due Date: November 07, 2023
Payment Status: Pending
Bill To:
Client Name: Grace Akello
Address: House 12, Bukoto Street, Kamwokya
Kampala, Uganda
Contact: +256 772 987 654
Insurance Provider: Uganda National Social Security Fund (NSSF) - Private Scheme
Policy Number: NSSF-PRV-88210
| # | Description of Midwifery Services | Date of Service | Unit Price (UGX) | Total (UGX) |
|---|---|---|---|---|
| 1 |
Initial Prenatal Consultation & Assessment Comprehensive health history review, physical examination, and risk assessment for pregnancy in Kampala. Includes counseling on nutrition and lifestyle adjustments specific to the local environment. |
Sept 10, 2023 | 150,000 | 150,000 |
| 2 |
Antenatal Care Visits (Package of 4) Routine midwife-led checkups including fetal heart rate monitoring, blood pressure checks, urine analysis, and growth measurement. Conducted at our Nakawa clinic facility. |
Sept 25 - Oct 15, 2023 | 100,000 | 400,000 |
| 3 |
Ultrasound Coordination & Interpretation Referral management and preliminary interpretation of sonographic results to ensure fetal well-being and correct positioning. |
Oct 05, 2023 | 75,000 | 75,000 |
| 4 |
Childbirth Education Workshop One-on-one session covering labor stages, breathing techniques, pain management options, and postpartum care expectations within the Ugandan healthcare context. |
Oct 12, 2023 | 120,000 | 120,000 |
| 5 |
Emergency On-Call Availability Fee Guaranteed 24/7 access to a qualified midwife for urgent consultations or complications during the final trimester in the Kampala metropolitan area. |
Oct 01 - Oct 31, 2023 | 200,000 | 200,000 |
| 6 |
Postnatal Home Visit Home-based assessment of mother and newborn within 48 hours of discharge. Includes breastfeeding support, umbilical cord care check, and maternal recovery evaluation. |
Oct 20, 2023 | 180,000 | 180,000 |
Payment Instructions:
Please remit payment within 14 days of the invoice date. Payments can be made via Mobile Money (MTN/Airtel), Bank Transfer, or Cash at our Kampala office.
- Mobile Money: +256 700 123 456 (Kampala Maternal Care)
- Bank: Stanbic Bank Uganda Ltd
- Branch: Nakawa Branch
- Account Name: Kampala Maternal Care Services Ltd
- Account Number: 1002345678901
Reference: Please use Invoice Number INV-UG-2023-0892 as the payment reference.
Terms and Conditions:
1. This invoice represents professional midwifery services rendered in accordance with the standards set by the Uganda Nurses and Midwives Council.
2. Late payments may incur a penalty fee of 2% per month on the outstanding balance.
3. Insurance claims should be submitted directly by the client using this invoice as supporting documentation.
4. All medical records and consultation notes remain the property of Kampala Maternal Care Services but are accessible to the client upon request.
5. Disputes regarding this invoice must be raised within 7 days of receipt.
Authorized By:
Sarah Nalubega, RN, RM
Lead Midwife & Director
Kampala Maternal Care Services
Received By:
__________________________
Name & Signature
Date: ____________________
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT