Invoice Ophthalmologist in United Arab Emirates Abu Dhabi –Free Word Template Download with AI
Specialized Ophthalmology Services
Al Reem Island, Abu Dhabi, United Arab Emirates
License No: DHA-OPH-12345
Tax Registration No: TRN-987654321
Invoice Number: INV-2023-00123
Date: October 15, 2023
Due Date: November 15, 2023
Patient Name: John Doe
Address: 123 Yas Island, Abu Dhabi, UAE
Contact: +971 50 123 4567
Email: [email protected]
This invoice details the ophthalmological services provided by our certified Ophthalmologist at Abu Dhabi Vision Care Center, located in the United Arab Emirates Abu Dhabi. Our clinic is committed to providing top-tier eye care services in compliance with the regulations set by the Department of Health – Abu Dhabi (DoH).
| Description | Quantity | Unit Price (AED) | Total (AED) |
|---|---|---|---|
| Comprehensive Eye Examination | 1 | 350.00 | 350.00 |
| Dilated Fundus Examination | 1 | 200.00 | 200.00 |
| Optical Coherence Tomography (OCT) | 1 | 450.00 | 450.00 |
| Visual Field Test | 1 | 300.00 | 300.00 |
| Corneal Topography | 1 | 250.00 | 250.00 |
| Prescription Glasses Consultation | 1 | 150.00 | 150.00 |
| Contact Lens Fitting | 1 | 200.00 | 200.00 |
| Glaucoma Screening | 1 | 300.00 | 300.00 |
| Cataract Evaluation | 1 | 400.00 | 400.00 |
| Retinal Imaging | 1 | 350.00 | 350.00 |
Subtotal: AED 3,000.00
VAT (5%): AED 150.00
Total Amount Due: AED 3,150.00
Payment is due within 30 days of the invoice date. Late payments may incur a penalty of 2% per month on the outstanding balance. Please make payments via bank transfer to the following account:
Bank Name: Emirates NBD
Account Name: Abu Dhabi Vision Care Center
Account Number: 1234567890123
IBAN: AE123456789012345678901
SWIFT Code: EBILAEAD
This invoice is issued in accordance with the tax regulations of the United Arab Emirates Abu Dhabi. All services provided are subject to the terms and conditions agreed upon at the time of service. Our Ophthalmologist has conducted a thorough examination and provided recommendations based on the latest medical standards.
If you have any questions regarding this invoice or the services provided, please contact our billing department at [email protected] or call +971 2 123 4567.
Authorized Signature:
Dr. Jane Smith, MD
Chief Ophthalmologist
Abu Dhabi Vision Care Center
⬇️ Download as DOCX Edit online as DOCXCreate your own Word template with our GoGPT AI prompt:
GoGPT