Invoice Optometrist in Colombia Bogotá –Free Word Template Download with AI
NIT: 900.123.456-7
Address: Calle 72 #19-45, Oficina 301, Chapinero
City: Bogotá D.C., Colombia
Phone: +57 (1) 234-5678
Email: facturació[email protected]
License No: RES-2021-00456789
Invoice Number: FAC-2023-0892
Issue Date: October 24, 2023
Due Date: November 24, 2023
Payment Method: Bank Transfer / Cash
Bill To:
Client Name: Juan Carlos Rodríguez Pérez
ID (Cédula): 1.098.765.432
Address: Carrera 15 #85-20, Apto 502
City: Bogotá D.C., Colombia
Email: [email protected]
Payment Details:
Bank: Bancolombia
Account Type: Savings
Account Number: 123-456789-00
Reference: FAC-2023-0892
| # | Description of Services / Products | Quantity | Unit Price (COP) | Total (COP) |
|---|---|---|---|---|
| 1 |
Comprehensive Optometric Examination Includes visual acuity test, refraction analysis, intraocular pressure measurement, and binocular vision assessment. Performed by licensed optometrist in Bogotá. |
1 | 150,000 | 150,000 |
| 2 |
Digital Retinal Imaging High-resolution fundus photography for early detection of diabetic retinopathy and macular degeneration. Standard procedure in Colombian optometry clinics. |
1 | 85,000 | 85,000 |
| 3 |
Premium Anti-Reflective Eyeglass Lenses High-index 1.67 lenses with blue light filter and UV protection. Custom-ground prescription lenses for optimal vision correction. |
2 | 220,000 | 440,000 |
| 4 |
Titanium Eyeglass Frame Lightweight, hypoallergenic titanium frame. Model: TC-2023-Bogotá. Includes professional adjustment and fitting. |
1 | 350,000 | 350,000 |
| 5 |
Low Vision Rehabilitation Consultation Specialized assessment and recommendation of assistive devices for patients with visual impairment. Conducted by certified optometrist. |
1 | 120,000 | 120,000 |
| 6 |
Contact Lens Fitting and Training Includes trial lenses, fitting assessment, and patient education on proper insertion, removal, and care of soft contact lenses. |
1 | 95,000 | 95,000 |
| 7 |
Annual Contact Lens Supply (6 Pairs) Monthly replacement soft contact lenses. Brand: Acuvue Oasys. Includes follow-up examination after 30 days. |
6 | 75,000 | 450,000 |
| 8 |
Orthokeratology (Ortho-K) Evaluation Specialized corneal topography and assessment for overnight vision correction therapy. Available at select optometry centers in Bogotá. |
1 | 180,000 | 180,000 |
Important Notes:
This invoice is issued in accordance with Colombian tax regulations (DIAN). All services were provided by licensed optometrists registered with the Colombian Ministry of Health. Payment is due within 30 days of the invoice date. Late payments may incur a 2% monthly interest charge. Please retain this document for your records and potential insurance reimbursement. For any questions regarding this invoice or your eye care treatment, please contact our office in Bogotá during business hours (Monday to Friday, 8:00 AM - 6:00 PM).
Legal Information: This invoice complies with Resolution 0000424 of 2015 issued by the DIAN (Dirección de Impuestos y Aduanas Nacionales) of Colombia. VISIÓN CLARA OPTOMETRY is a legally registered entity in Bogotá D.C., authorized to provide optometric services including vision correction, eye health examinations, and low vision rehabilitation. All optometrists practicing at this facility hold valid professional licenses issued by the Colombian government. This document serves as proof of purchase for tax purposes and warranty claims. The total amount includes the applicable Value Added Tax (IVA) of 19% as mandated by Colombian law. For electronic invoicing verification, please visit the DIAN website and enter the invoice number and NIT. This invoice is valid throughout the Republic of Colombia and may be used for insurance claims with EPS (Entidades Promotoras de Salud) or complementary health plans.
OFFICIALSTAMP Dr. María Fernanda López
Lead Optometrist
License No: 12345678 Client Signature
Juan Carlos Rodríguez Pérez
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT