Invoice Ophthalmologist in United Arab Emirates Dubai –Free Word Template Download with AI
Specialized Ophthalmology Center
License No: DXB-MOH-98765432
TRN: 100234567800003
P.O. Box 12345, Dubai, United Arab Emirates
Tel: +971 4 123 4567 | Email: [email protected]
Invoice Number: INV-2023-10-0045
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Payment Terms: Net 30 Days
Bill To:
Mr. Ahmed Al-Mansoori
Al Barsha South, Villa 45
Dubai, United Arab Emirates
Emirates ID: 784-1985-1234567-8
Phone: +971 50 987 6543
Pay To:
Emirates Vision Care LLC
Bank Name: Emirates NBD
Account Name: Emirates Vision Care LLC
Account Number: 1001 2345 6789 0123
IBAN: AE07 0331 2345 6789 0123 456
Swift Code: EBILAEAD
| # | Description of Ophthalmological Services | Quantity | Unit Price (AED) | Total (AED) |
|---|---|---|---|---|
| 1 |
Comprehensive Ophthalmological Examination Includes visual acuity testing, refraction, slit-lamp examination, and intraocular pressure measurement. Conducted by a certified Ophthalmologist in Dubai. |
1 | 350.00 | 350.00 |
| 2 |
Dilated Fundus Examination Detailed retinal assessment using mydriatic agents to evaluate the health of the retina, optic nerve, and macula. Essential for diabetic retinopathy screening in the UAE. |
1 | 200.00 | 200.00 |
| 3 |
Optical Coherence Tomography (OCT) Advanced imaging of the retina and optic nerve head. Non-invasive diagnostic procedure performed at our Dubai clinic to detect early signs of glaucoma and macular degeneration. |
1 | 450.00 | 450.00 |
| 4 |
Corneal Topography Detailed mapping of the corneal surface curvature. Required for contact lens fitting and pre-operative assessment for refractive surgery. |
1 | 300.00 | 300.00 |
| 5 |
Prescription Eyewear Consultation Professional consultation for prescription glasses including lens type recommendation (anti-reflective, blue light filter) and frame selection assistance. |
1 | 150.00 | 150.00 |
| 6 |
Follow-up Consultation with Ophthalmologist Post-examination review of diagnostic results and discussion of treatment plan. Includes medication prescription if necessary. |
1 | 250.00 | 250.00 |
| Subtotal: | 1,700.00 AED |
| VAT (5%): | 85.00 AED |
| Total Amount Due: | 1,785.00 AED |
Important Notes & Terms:
This invoice is issued in accordance with the Federal Decree-Law No. (8) of 2017 on Value Added Tax in the United Arab Emirates. The VAT registration number is clearly stated above for your records.
All ophthalmological services provided by our certified Ophthalmologists in Dubai are covered under the quality standards set by the Dubai Health Authority (DHA). Please retain this invoice for your personal records and insurance claims.
Payment is due within 30 days from the date of issue. Late payments may incur a penalty of 2% per month on the outstanding balance, as per UAE commercial regulations.
For insurance claims, please submit this original invoice along with the detailed medical report and treatment summary to your insurance provider. Our billing department is available to assist with pre-authorizations and direct billing arrangements with major UAE insurance companies.
If you have any questions regarding this invoice or the services provided by our Ophthalmology team, please contact our billing department at +971 4 123 4567 or email [email protected]. We are committed to providing transparent and professional healthcare services in Dubai and across the United Arab Emirates.
Thank you for choosing Emirates Vision Care for your eye health needs. We appreciate your trust in our specialized Ophthalmological services and look forward to continuing to serve you.
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