Invoice Ophthalmologist in Nepal Kathmandu –Free Word Template Download with AI
Specialized Ophthalmology Clinic
Thamel, Kathmandu, Nepal
Phone: +977-1-4XXXXXX
Email: [email protected]
PAN/VAT: 123456789
Invoice Number: INV-2024-0045
Date: October 15, 2024
Due Date: October 30, 2024
Payment Terms: Net 15 Days
Billed To:
Patient Name: Rajesh Sharma
Address: Lazimpat, Kathmandu, Nepal
Phone: +977-98XXXXXXXX
Email: [email protected]
Insurance Provider: Nepal Life Insurance Co. Ltd.
Policy Number: NLI-OPH-2024-789
| Description | Quantity | Unit Price (NPR) | Total (NPR) |
|---|---|---|---|
| Comprehensive Ophthalmological Examination by Senior Ophthalmologist | 1 | 2,500.00 | 2,500.00 |
| Refraction Test and Prescription for Corrective Lenses | 1 | 1,200.00 | 1,200.00 |
| Dilated Fundus Examination with Retinal Imaging | 1 | 3,000.00 | 3,000.00 |
| Anterior Segment OCT Scan | 1 | 2,800.00 | 2,800.00 |
| Intraocular Pressure Measurement (Tonometry) | 1 | 800.00 | 800.00 |
| Prescription Medications: Artificial Tears (1 month supply) | 2 | 450.00 | 900.00 |
| Prescription Medications: Antibiotic Eye Drops (1 course) | 1 | 600.00 | 600.00 |
| Follow-up Consultation with Ophthalmologist (within 2 weeks) | 1 | 1,500.00 | 1,500.00 |
| Administrative Fee for Medical Records and Documentation | 1 | 300.00 | 300.00 |
| Subtotal: | NPR 13,600.00 |
| VAT (13%): | NPR 1,768.00 |
| Total Amount Due: | NPR 15,368.00 |
Important Notes and Terms:
1. This invoice is issued by Kathmandu Vision Care Center, a licensed ophthalmology clinic operating in Kathmandu, Nepal, in accordance with the regulations set forth by the Nepal Medical Council and the Department of Health Services.
2. All services rendered were performed by qualified ophthalmologists and certified medical staff specializing in eye care and vision health.
3. Payment is due within 15 days of the invoice date. Late payments may incur a penalty of 2% per month on the outstanding balance.
4. Accepted payment methods include cash (Nepalese Rupees), bank transfer, credit/debit cards, and mobile banking services available in Nepal.
5. For bank transfers, please use the following details:
- Bank Name: Nepal Bank Limited
- Branch: Thamel, Kathmandu
- Account Name: Kathmandu Vision Care Center
- Account Number: 0123456789012
- SWIFT Code: NBLKNPKA
6. Please include the invoice number (INV-2024-0045) as a reference when making payments.
7. If you have any questions regarding this invoice or the services provided, please contact our billing department at +977-1-4XXXXXX or email [email protected].
8. This invoice serves as an official receipt for tax and insurance purposes in Nepal. Please retain a copy for your records.
9. All medical services and treatments provided are subject to the professional judgment of the attending ophthalmologist and are designed to ensure the highest standard of eye care in Kathmandu.
10. In case of any discrepancies, please notify us within 7 days of receiving this invoice.
Authorized by:
Dr. Anita Maharjan, MD (Ophthalmology)Received by:
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