Invoice Occupational Therapist in India New Delhi –Free Word Template Download with AI
Specialized Occupational Therapy Services
Plot No. 45, Sector 12, Dwarka
New Delhi, India - 110075
Phone: +91-11-4567-8900
Email: [email protected]
GSTIN: 07AABCD1234E1Z5
Invoice #: DT-OT-2023-0892
Date: October 24, 2023
Due Date: November 07, 2023
Payment Terms: Net 14 Days
BILL TO:
Mr. Rajesh Kumar
Flat 302, Green Valley Apartments
Sector 21, Vasant Kunj
New Delhi, India - 110070
PAN: ABCDE1234F
PATIENT DETAILS:
Name: Mrs. Sunita Kumar
Age: 54 Years
Diagnosis: Post-Stroke Rehabilitation (Right Hemiparesis)
Referring Physician: Dr. A. Verma, Neurology Dept.
| # | Description of Occupational Therapy Services | Qty / Hours | Rate (INR) | Amount (INR) | GST (18%) |
|---|---|---|---|---|---|
| 1 | Initial Comprehensive Evaluation: Detailed assessment of motor skills, cognitive function, and Activities of Daily Living (ADLs) conducted at our New Delhi clinic. Includes standardized testing and goal setting. | 1 | 2,500.00 | 2,500.00 | 450.00 |
| 2 | One-on-One Therapy Sessions (Oct 1-15): 10 sessions focused on upper limb rehabilitation, fine motor skill enhancement, and adaptive strategies for dressing and grooming. | 10 | 1,200.00 | 12,000.00 | 2,160.00 |
| 3 | Home Modification Consultation: Site visit to the client's residence in Vasant Kunj, New Delhi, to assess safety hazards and recommend ergonomic modifications for independent living. | 1 | 3,000.00 | 3,000.00 | 540.00 |
| 4 | Adaptive Equipment Provision: Supply of specialized dressing aids, weighted utensils, and a reacher-grabber tool tailored to the patient's specific needs. | 1 | 4,500.00 | 4,500.00 | 810.00 |
| 5 | Cognitive Rehabilitation Program: 5 sessions targeting memory, attention, and problem-solving skills to improve daily functioning and safety awareness. | 5 | 1,500.00 | 7,500.00 | 1,350.00 |
| 6 | Family Caregiver Training: Educational session for family members on transfer techniques, positioning, and how to support the patient's therapy goals at home. | 2 | 1,000.00 | 2,000.00 | 360.00 |
Payment Instructions & Terms
Bank Transfer Details:
Bank Name: State Bank of India
Branch: Dwarka Sector 12, New Delhi
Account Name: Delhi Rehab & Wellness Center Pvt. Ltd.
Account Number: 30589210456789
IFSC Code: SBIN0012345
UPI ID: delhirehab@sbibank
Terms:
- Please quote the Invoice Number (DT-OT-2023-0892) in the payment remarks.
- Payment is due within 14 days of the invoice date.
- A late fee of 1.5% per month will be applied to overdue balances.
- This invoice is valid for tax purposes under the GST regime of India.
Create your own Word template with our GoGPT AI prompt:
GoGPT