Invoice Nurse in Indonesia Jakarta –Free Word Template Download with AI
Professional Healthcare Solutions
Jl. Sudirman No. 45, Menteng
Jakarta Pusat, Indonesia Jakarta 10310
Email: [email protected] | Phone: +62 21 555 0199
NPWP: 01.234.567.8-901.000
Invoice Number: INV-JKT-2023-0892
Date Issued: October 24, 2023
Due Date: November 07, 2023
Service Period: October 01, 2023 - October 31, 2023
Bill To:
PT. Global Health Insurance Indonesia
Attn: Claims Department
Jl. Gatot Subroto Kav. 52-53
Jakarta Selatan, Indonesia Jakarta 12710
Client Reference ID: GH-88291
Pay To:
Bank: Bank Central Asia (BCA)
Account Name: PT. MediCare Elite Nursing
Account Number: 123-456-7890
SWIFT Code: CENAIDJA
Please include Invoice Number in transfer remarks.
| # | Description of Nursing Services | Rate (IDR) | Hours/Qty | Amount (IDR) |
|---|---|---|---|---|
| 1 |
Senior Registered Nurse (Sister) - In-Patient Care Provision of 24-hour continuous nursing care for patient recovery in Jakarta facility. Includes vital signs monitoring, medication administration, and wound care management. |
350,000 | 168 | 58,800,000 |
| 2 |
Specialized Pediatric Nurse Consultation Expert assessment and developmental monitoring for pediatric patient. Includes consultation with parents and coordination with pediatricians in Indonesia Jakarta. |
500,000 | 8 | 4,000,000 |
| 3 |
Post-Operative Nursing Support Intensive care following surgical procedure. Includes pain management, mobility assistance, and infection control protocols. |
400,000 | 40 | 16,000,000 |
| 4 |
Medical Equipment & Supplies Provision of sterile bandages, IV fluids, and monitoring devices used during the nursing shift. |
- | 1 | 2,500,000 |
| 5 |
Emergency Night Shift Surcharge Additional fee for Nurse availability during emergency night hours (22:00 - 06:00) as per Jakarta healthcare regulations. |
150,000 | 24 | 3,600,000 |
Amount in words: Ninety-Four Million Two Hundred Thirty-Nine Thousand Indonesian Rupiah.
Terms and Conditions & Important Notes:
- Payment Terms: Payment is due within 14 days of the invoice date. Late payments may incur a penalty of 2% per month.
- Currency: All amounts are quoted in Indonesian Rupiah (IDR). This Invoice is valid for transactions within Indonesia Jakarta.
- Nurse Qualifications: All nursing staff assigned are licensed by the Indonesian Nurses Association (PERKIN) and meet the Ministry of Health standards.
- Disputes: Any discrepancies regarding the services provided by the Nurse must be reported within 7 days of receiving this document.
- Confidentiality: Patient data handled by our nursing team is protected under Indonesian privacy laws.
- Bank Charges: Any bank transfer fees are the responsibility of the payer.
Authorized by:
Dr. Sarah Wijaya, RN
Head of Nursing Operations
Signature & StampReceived by:
Finance Department
PT. Global Health Insurance
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