Invoice Optometrist in Algeria Algiers –Free Word Template Download with AI
Dr. Karim Benali, Optometrist
15 Rue Didouche Mourad, Hydra
16000 Algiers, Algeria
Tel: +213 (0) 21 60 12 34
Email: [email protected]
NIF: 000123456789012 | NIS: 000987654321098
Bill To:Client Name: Samia Khelifi
Address: 42 Boulevard Mohamed V
City: Bab El Oued, Algiers
Postal Code: 16000
Country: Algeria
Phone: +213 (0) 555 12 34 56
Service Details:Patient Name: Samia Khelifi
Date of Service: October 24, 2023
Service Type: Comprehensive Eye Examination & Optical Dispensing
Prescription ID: RX-ALG-8892
Description of Services and Goods| # | Description | Quantity | Unit Price (DZD) | Total (DZD) |
|---|---|---|---|---|
| 1 |
Comprehensive Optometric Examination Includes visual acuity testing, refraction, intraocular pressure measurement, and dilated fundus examination performed by a licensed Optometrist in Algiers. |
1 | 5,000.00 | 5,000.00 |
| 2 |
Binocular Vision Assessment Specialized testing for eye coordination and focusing ability, essential for diagnosing convergence insufficiency. |
1 | 3,500.00 | 3,500.00 |
| 3 |
High-Index Polycarbonate Lenses (Pair) Prescription lenses with anti-reflective coating and UV protection. Refractive index 1.67. |
1 | 18,000.00 | 18,000.00 |
| 4 |
Titanium Optical Frame Lightweight, hypoallergenic titanium frame. Brand: Visionaire. Color: Matte Black. |
1 | 12,500.00 | 12,500.00 |
| 5 |
Dispensing and Adjustment Fee Professional fitting of the eyewear to ensure optimal comfort and optical alignment. |
1 | 2,000.00 | 2,000.00 |
| 6 |
Protective Eyewear Case and Cleaning Kit Includes microfiber cloth and hard-shell case. |
1 | 1,500.00 | 1,500.00 |
| Subtotal: | 42,500.00 DZD |
| VAT (19%): | 8,075.00 DZD |
| Discount: | 0.00 DZD |
| TOTAL DUE: | 50,575.00 DZD |
Please make payment within 14 days of the invoice date. Payments can be made via bank transfer or cash at our Algiers clinic.
Bank Name: Banque Nationale d'Algérie (BNA)
Branch: Hydra, Algiers
Account Name: Algier Vision Optometry SARL
Account Number (RIB): 000123456789012345678901
SWIFT/BIC: BNAEDZAA
- This invoice is issued in accordance with the commercial laws of Algeria.
- Goods sold are subject to a 30-day warranty against manufacturing defects. This warranty does not cover damage caused by misuse or accidents.
- Prescriptions provided by this Optometrist are valid for one year from the date of the examination.
- Any disputes regarding this invoice shall be subject to the jurisdiction of the courts of Algiers.
- Please quote the Invoice Number (INV-2023-10-045) when making payment.
Thank you for choosing Algier Vision Optometry for your eye care needs in Algiers.
Authorized Signature
Dr. Karim Benali
Lead Optometrist
Received By (Client)
Date: _______________
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