Invoice Optometrist in Philippines Manila –Free Word Template Download with AI
License No.: OPT-2023-MNL-8842
Unit 405, Medical Plaza Tower, Ayala Avenue
Ermita, Manila, Metro Manila, Philippines 1000
Tel: (+632) 8555-0199 | Email: [email protected]
TIN: 123-456-789-000
Invoice #: INV-2023-10-045
Date: October 24, 2023
Due Date: November 24, 2023
Status: UNPAID
Bill To:
Mr. Juan Dela Cruz
123 Rizal Street, Barangay San Miguel
Manila, Philippines 1005
Contact: (+63) 917-123-4567
Email: [email protected]
Service Location:
Manila Vision Care Optometry
Consultation Room B
Manila, Philippines
| # | Description of Optometry Services & Products | Quantity | Unit Price (PHP) | Total (PHP) |
|---|---|---|---|---|
| 1 |
Comprehensive Eye Examination Includes visual acuity test, refraction, tonometry (eye pressure), and retinal screening. Performed by a licensed Optometrist in Manila. |
1 | 1,500.00 | 1,500.00 |
| 2 |
Premium Anti-Reflective Lenses (Pair) High-index 1.67 lenses with blue light filter coating. Custom ground for prescription. |
1 | 4,500.00 | 4,500.00 |
| 3 |
Titanium Semi-Rimless Frame Model: Manila Series TS-202. Includes adjustment and fitting by certified optician. |
1 | 3,200.00 | 3,200.00 |
| 4 |
Dry Eye Management Consultation Specialized assessment and treatment plan for ocular surface disease. |
1 | 800.00 | 800.00 |
| 5 |
Lubricating Eye Drops (Prescription) 15ml bottle of preservative-free artificial tears. |
2 | 350.00 | 700.00 |
Payment Terms & Conditions
This invoice is issued by Manila Vision Care Optometry, a registered healthcare provider in the Philippines. Payment is due within 30 days from the date of issue. Please make checks payable to "Manila Vision Care Optometry Inc." or use our bank transfer details below:
Bank: BDO Unibank
Account Name: Manila Vision Care Optometry Inc.
Account No: 1234-5678-9012
Reference: INV-2023-10-045
Late payments may incur a penalty of 1.5% per month. Please contact our billing department in Manila if you have any questions regarding this invoice or your optometry services.
Important: This document serves as an official receipt for tax purposes in the Philippines. Please retain this invoice for your records.
Authorized Signature
Dr. Maria Santos, O.D.
Licensed Optometrist
Received By
Date: _______________
Signature: _______________
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