Invoice Ophthalmologist in Philippines Manila –Free Word Template Download with AI
Dr. Elena Santos, M.D., FPOphth
Board Certified Ophthalmologist
Unit 405, Medical Arts Tower, Ayala Avenue
Makati City, Metro Manila, Philippines 1226
Tel: +63 (2) 8888-9999 | Email: [email protected]
TIN: 123-456-789-000 | BIR Reg. No. 000-000-000-000
Invoice #: INV-2023-10-045
Date Issued: October 24, 2023
Due Date: November 24, 2023
Service Location: Manila, Philippines
BILL TO:
Mr. Juan Dela Cruz
123 Rizal Street, Barangay San Miguel
Manila City, Metro Manila, Philippines 1005
Contact: +63 917 123 4567
Email: [email protected]
| # | Description of Ophthalmology Services | Quantity | Unit Price (PHP) | Total (PHP) |
|---|---|---|---|---|
| 1 |
Comprehensive Ophthalmologic Examination Includes visual acuity testing, refraction, slit-lamp biomicroscopy, and tonometry. Performed by a licensed Ophthalmologist in Manila. |
1 | 2,500.00 | 2,500.00 |
| 2 |
Dilated Fundus Examination Detailed inspection of the retina, optic nerve, and macula using mydriatic agents. Essential for diagnosing diabetic retinopathy and glaucoma. |
1 | 1,500.00 | 1,500.00 |
| 3 |
Optical Coherence Tomography (OCT) High-resolution cross-sectional imaging of the retina. Used for assessing macular degeneration and glaucoma progression. |
1 | 3,200.00 | 3,200.00 |
| 4 |
Prescription Eyeglasses (Single Vision) Includes frame selection and high-index anti-reflective lenses. Dispensed at our Manila clinic. |
1 | 4,500.00 | 4,500.00 |
| 5 |
Consultation Fee - Follow-up Visit Post-treatment review and medication adjustment by the attending Ophthalmologist. |
1 | 1,800.00 | 1,800.00 |
Payment Terms & Important Information
This invoice is issued in accordance with the regulations of the Bureau of Internal Revenue (BIR) of the Philippines. Payment is due within 30 days from the date of issue. Late payments may incur a penalty of 1.5% per month on the outstanding balance.
Accepted Payment Methods: Bank Transfer (BDO, BPI, Metrobank), Credit/Debit Card (Visa, Mastercard), GCash, Maya, or Cash at our Manila office.
Bank Details:
Bank: Bank of the Philippine Islands (BPI)
Account Name: Manila Vision & Eye Care Specialists Inc.
Account Number: 1234-5678-90
Branch: Ayala Avenue, Makati City
Please include your Invoice Number (INV-2023-10-045) as the reference for all payments. For insurance claims, please contact our billing department for an official receipt and detailed medical abstract.
Thank you for trusting our Ophthalmologist team in Manila for your eye care needs. We are committed to providing world-class ophthalmology services in the Philippines.
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