Invoice Optometrist in Qatar Doha –Free Word Template Download with AI
Professional Optometrist Services
Building 45, Street 78, Zone 32
West Bay, Doha, Qatar
P.O. Box: 23456
Phone: +974 4412 3456
Email: [email protected]
VAT Registration: 12345678900
Commercial Registration: CR-2024-7890
| Invoice Number: | INV-2024-0892 |
| Date of Issue: | November 15, 2024 |
| Due Date: | December 15, 2024 |
| Payment Terms: | Net 30 Days |
| Currency: | QAR (Qatari Riyal) |
Bill To:
Mr. Ahmed Al-Thani
Al Rayyan Municipality
Building 12, Street 45
Doha, Qatar
Phone: +974 3345 6789
Email: [email protected]
National ID: 29345678901
Service Details:
Patient Name: Mr. Ahmed Al-Thani
Appointment Date: November 14, 2024
Attending Optometrist: Dr. Sarah Johnson, OD
License Number: MOH-QAT-7890
Insurance Provider: Bupa Qatar
Policy Number: BUPA-QA-456789
Claim Reference: CLM-2024-3456
| # | Description of Optometry Services & Products | Quantity | Unit Price (QAR) | Total (QAR) | VAT (5%) |
|---|---|---|---|---|---|
| 1 | Comprehensive Eye Examination - Full diagnostic assessment including visual acuity testing, refraction, eye pressure measurement, and retinal evaluation performed by licensed optometrist in Doha | 1 | 350.00 | 350.00 | 17.50 |
| 2 | Dilated Fundus Examination - Detailed retinal and optic nerve assessment using mydriatic drops for comprehensive eye health evaluation | 1 | 200.00 | 200.00 | 10.00 |
| 3 | Prescription Eyeglasses - Premium anti-reflective coated lenses with progressive multifocal design, including consultation and fitting by certified optometrist | 1 | 1,200.00 | 1,200.00 | 60.00 |
| 4 | Titanium Semi-Rimless Frame - High-quality durable frame selected and fitted during optometry consultation in our Doha clinic | 1 | 450.00 | 450.00 | 22.50 |
| 5 | Blue Light Filtering Coating - Advanced digital eye strain protection coating applied to prescription lenses | 1 | 150.00 | 150.00 | 7.50 |
| 6 | Contact Lens Fitting and Evaluation - Professional contact lens assessment, trial, and prescription by qualified optometrist | 1 | 250.00 | 250.00 | 12.50 |
| 7 | Monthly Disposable Contact Lenses (Box of 6) - Premium silicone hydrogel lenses prescribed following optometry examination | 2 | 180.00 | 360.00 | 18.00 |
| 8 | Eye Health Consultation - Follow-up consultation regarding dry eye management and preventive eye care recommendations | 1 | 150.00 | 150.00 | 7.50 |
| 9 | Preservative-Free Artificial Tears (30ml) - Recommended lubricating eye drops for dry eye symptom relief | 2 | 45.00 | 90.00 | 4.50 |
| 10 | UV Protection Sunglasses - Prescription sunglasses with 100% UV protection, professionally fitted by optometrist | 1 | 650.00 | 650.00 | 32.50 |
| Subtotal: | QAR 3,850.00 |
| VAT (5%): | QAR 192.50 |
| Insurance Coverage: | -QAR 1,500.00 |
| Grand Total Due: | QAR 2,542.50 |
Payment Instructions:
Bank Transfer:
Bank Name: Qatar National Bank (QNB)
Account Name: Doha Vision Optometry Center W.L.L.
IBAN: QA3000000000000000000000
SWIFT/BIC: QNBQQA
Branch: West Bay, Doha, Qatar
Reference: Please include Invoice Number INV-2024-0892 in your payment reference.
Cash/Card: Payments accepted at our Doha clinic during business hours (Sunday-Thursday: 9:00 AM - 7:00 PM, Saturday: 10:00 AM - 3:00 PM).
Terms and Conditions:
1. This invoice is issued by Doha Vision Optometry Center, a licensed optometry practice operating in Doha, Qatar, in accordance with the Ministry of Public Health regulations.
2. All optometry services are provided by qualified and licensed optometrists registered with the Qatar Council for Healthcare Practitioners.
3. Payment is due within 30 days from the invoice date. Late payments may incur a penalty of 2% per month on the outstanding balance.
4. Insurance claims have been submitted on behalf of the patient. The amount shown as insurance coverage is an estimate and subject to final approval by the insurance provider.
5. Prescription eyewear comes with a 12-month warranty against manufacturing defects. Frames and lenses must be cared for according to the instructions provided by our optometrist.
6. Contact lens prescriptions are valid for 12 months from the date of the optometry examination, as per Qatar healthcare regulations.
7. All prices are quoted in Qatari Riyals (QAR) and include applicable taxes as required by Qatar law.
8. This invoice serves as an official receipt for tax and accounting purposes in Qatar.
9. For any questions regarding this invoice or our optometry services, please contact our billing department at +974 4412 3456 or email [email protected].
10. We appreciate your trust in our professional optometry services in Doha, Qatar. Your eye health is our priority.
Authorized SignatureDoha Vision Optometry Center Patient Signature
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT