Invoice Optometrist in Senegal Dakar –Free Word Template Download with AI
Specialized Eye Care Center
12 Avenue Cheikh Anta Diop, Sacré-Cœur 3
Dakar, Senegal
Tel: +221 33 869 12 34 | Email: [email protected]
Registre de Commerce: RM-DK-2023-B-12345
IFU: SN-98765432100
Invoice Number: INV-DK-2023-0892
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Payment Terms: Net 14 Days
Bill To:
Monsieur Ibrahima Diallo
45 Rue de Thiong, Almadies
Dakar, Senegal
NIN: SN-IND-456789
Phone: +221 77 123 45 67
Service Location:
Dakar Vision Optometry Clinic
Consultation Room B
Sacré-Cœur, Dakar
Senegal
| # | Description of Optometry Services & Goods | Quantity | Unit Price (XOF) | Total Amount (XOF) |
|---|---|---|---|---|
| 1 |
Comprehensive Ophthalmological Examination Includes visual acuity test, refraction analysis, intraocular pressure measurement, and retinal screening performed by a certified Optometrist in Dakar. |
1 | 35,000 | 35,000 |
| 2 |
Premium Anti-Reflective Lenses (Bifocal) High-index 1.67 lenses with blue light filter and anti-scratch coating. Custom ground prescription for progressive vision correction. |
1 Pair | 120,000 | 120,000 |
| 3 |
Designer Titanium Eyeglass Frames Model: Dakar-Titan-X. Lightweight, hypoallergenic titanium alloy frame suitable for daily wear in tropical climates. |
1 | 85,000 | 85,000 |
| 4 |
Optical Dispensing and Adjustment Professional fitting of lenses into frames, pupillary distance verification, and ergonomic adjustment for facial comfort. |
1 | 15,000 | 15,000 |
| 5 |
Protective Hard Case & Cleaning Kit Includes microfiber cleaning cloth, lens cleaning solution (50ml), and durable hard-shell carrying case. |
1 | 10,000 | 10,000 |
| 6 |
Follow-up Consultation (3 Months) Scheduled review appointment to assess adaptation to new prescription and check ocular health. |
1 | 20,000 | 20,000 |
| Subtotal: | 285,000 XOF |
| VAT (18% - Senegal Standard Rate): | 51,300 XOF |
| Discount (Loyalty Member): | -10,000 XOF |
| Total Amount Due: | 326,300 XOF |
Payment Instructions & Bank Details
Please make payment within 14 days of the invoice date. Payments can be made via bank transfer to our account in Dakar:
Bank Name: Ecobank Senegal
Account Name: Dakar Vision Optometry SARL
Account Number: 1234567890123
SWIFT/BIC: ECOBSNSX
IBAN: SN52 ECOB 1234 5678 9012 3456
Alternatively, payments are accepted via Wave, Orange Money, or cash at our clinic location in Sacré-Cœur.
Terms and Conditions
1. Validity: This invoice is valid for 30 days from the date of issue. Prices are subject to change after this period.
2. Prescription Accuracy: The Optometrist guarantees the accuracy of the prescription based on the examination performed. However, the clinic is not liable for errors resulting from incorrect information provided by the patient regarding their medical history.
3. Warranty: All eyeglass frames and lenses come with a 12-month warranty against manufacturing defects. This warranty does not cover damage caused by misuse, accidents, or normal wear and tear.
4. Refunds: Refunds for custom-made lenses are only processed if a manufacturing defect is confirmed by our certified Optometrist within 14 days of delivery.
5. Late Payments: A late fee of 2% per month will be applied to any outstanding balance after the due date.
6. Jurisdiction: This invoice and any disputes arising from it are governed by the laws of the Republic of Senegal. Any legal proceedings will be conducted in the courts of Dakar.
Dakar Vision Optometry SARL is a registered healthcare provider in Senegal, dedicated to providing high-quality eye care services to the community of Dakar and surrounding regions. Our team of certified Optometrists adheres to the highest standards of professional ethics and clinical practice. This document serves as an official record of the transaction and may be used for tax purposes in accordance with Senegalese fiscal regulations. Please retain this invoice for your records. For any questions regarding this invoice or your eye care treatment, please contact our administrative office during business hours (Monday to Friday, 8:00 AM - 6:00 PM).
Authorized Signature
Dr. Awa Ndiaye, Lead Optometrist
Dakar Vision Optometry
Client Acknowledgment
Received and Accepted
Date: _______________
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