Invoice Ophthalmologist in India Bangalore –Free Word Template Download with AI
#45, 2nd Floor, MG Road
Indiranagar, Bangalore, Karnataka
India - 560038
Phone: +91 80 1234 5678
Email: [email protected]
INVOICE
Invoice No: INV-BLR-2023-0892
Date: October 24, 2023
Due Date: November 07, 2023
Bill To
Mr. Arjun Mehta
12, Residency Road
Central Bangalore, Karnataka
India - 560025
Mobile: +91 98765 43210
Email: [email protected]
| # | Service Description | Quantity | Rate (INR) | Amount (INR) |
|---|---|---|---|---|
| 1 |
Comprehensive Ophthalmic Examination Includes visual acuity testing, refraction, slit-lamp biomicroscopy, and intraocular pressure measurement (Tonometry). Performed by a Senior Consultant Ophthalmologist. |
1 | 1,500.00 | 1,500.00 |
| 2 |
Dilated Fundus Examination Detailed retinal assessment using mydriatic drops to evaluate the optic nerve, macula, and retinal vasculature for signs of diabetic retinopathy or glaucoma. |
1 | 1,200.00 | 1,200.00 |
| 3 |
Optical Coherence Tomography (OCT) High-resolution cross-sectional imaging of the retina to detect macular degeneration, edema, or nerve fiber layer defects. |
1 | 2,500.00 | 2,500.00 |
| 4 |
Prescription Spectacle Dispensing Supply of high-index anti-glare lenses with durable polycarbonate frames. Includes precise optical centering and fitting adjustment. |
1 | 4,800.00 | 4,800.00 |
| 5 |
Pharmacological Treatment Supply of lubricating eye drops (Artificial Tears) and antibiotic ointment as prescribed for post-examination care. |
2 | 350.00 | 700.00 |
Payment is due within 14 days of the invoice date. Please quote the Invoice Number (INV-BLR-2023-0892) in your payment reference.
Bank Name: State Bank of India
Branch: MG Road, Bangalore
Account Name: ClearVision Ophthalmology Center Pvt. Ltd.
Account Number: 30589200012345
IFSC Code: SBIN0001234
UPI ID: clearvisionblr@sb
This invoice serves as an official record of the ophthalmological services rendered at our clinic in Bangalore, India. The fees charged reflect the specialized expertise of our board-certified ophthalmologists and the use of state-of-the-art diagnostic equipment.
Please note that the GST charged is in accordance with the current Goods and Services Tax regulations applicable to healthcare services in India. If you have health insurance, this invoice can be submitted to your provider for reimbursement, subject to their policy terms.
For any queries regarding this invoice or your eye health, please contact our billing department or your treating ophthalmologist directly. We are committed to providing transparent billing and exceptional eye care to our patients in Bangalore and surrounding regions.
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