Invoice Ophthalmologist in Egypt Cairo –Free Word Template Download with AI
Specialized Eye Care in Egypt Cairo
Address: 15 El-Tahrir Street, Downtown, Cairo, Egypt
Phone: +20 2 2574 8899 | Email: [email protected]
Tax ID: 123-456-789000 | Commercial Reg: CR-987654
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Currency: Egyptian Pound (EGP)
Bill To:
Patient Name: Ahmed Hassan Mohamed
Address: 42 Zamalek Street, Giza, Cairo, Egypt
Phone: +20 100 123 4567
Insurance Provider: Bupa Egypt (Policy #BP-998877)
Service Provider Details:
Ophthalmologist: Dr. Sarah El-Sayed, MD, PhD
Specialization: Retinal Surgery & Refractive Procedures
Licence Number: MOH-Egypt-OPH-55432
Location: Nile Vision Clinic, Cairo, Egypt
| Description of Ophthalmological Services | Quantity | Unit Price (EGP) | Total (EGP) |
|---|---|---|---|
|
Comprehensive Eye Examination Includes visual acuity testing, refraction, slit-lamp examination, and intraocular pressure measurement. Performed by a certified Ophthalmologist in Cairo. |
1 | 800.00 | 800.00 |
|
Dilated Fundus Examination Detailed inspection of the retina, optic nerve, and macula using mydriatic drops. Essential for diagnosing diabetic retinopathy and glaucoma. |
1 | 600.00 | 600.00 |
|
Optical Coherence Tomography (OCT) Advanced imaging of the retinal layers to detect macular degeneration, edema, or nerve fiber layer defects. State-of-the-art technology available in Egypt Cairo clinics. |
1 | 1,500.00 | 1,500.00 |
|
Corneal Topography Mapping of the corneal surface curvature for contact lens fitting or pre-LASIK evaluation. Performed by specialist Ophthalmologist. |
1 | 900.00 | 900.00 |
|
Prescription Eyeglasses Consultation Final prescription verification and frame selection guidance. Includes anti-reflective coating recommendation. |
1 | 400.00 | 400.00 |
|
Follow-up Visit (Post-Consultation) Review of test results and discussion of treatment plan by the attending Ophthalmologist in Cairo. |
1 | 500.00 | 500.00 |
| Subtotal: | 4,700.00 EGP |
| VAT (14%): | 658.00 EGP |
| Total Amount Due: | 5,358.00 EGP |
Terms and Conditions:
This invoice is issued by Nile Vision Ophthalmology Center, a licensed medical facility operating in Egypt Cairo. All services were rendered by a qualified Ophthalmologist in accordance with Egyptian Ministry of Health standards. Payment is due within 30 days of the invoice date. Late payments may incur a 2% monthly interest charge. Insurance claims should be submitted directly to the provider with a copy of this invoice. For any discrepancies, please contact our billing department within 14 days. This document serves as an official receipt for tax and insurance purposes in Egypt.
Payment Methods Accepted: Bank Transfer (CIB, NBE), Credit/Debit Card, Cash (EGP only).
Bank Details: Commercial International Bank (CIB), Account Name: Nile Vision Clinic, IBAN: EG00 0000 0000 0000 0000 0000 0000.
Authorized Signature
Dr. Sarah El-Sayed
Lead Ophthalmologist
Patient Acknowledgment
Ahmed Hassan Mohamed
Date: _______________
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