Invoice Optometrist in Sri Lanka Colombo –Free Word Template Download with AI
Registered Optometrists in Sri Lanka
145 Galle Road, Colombo 03, Sri Lanka
Tel: +94 11 234 5678 | Email: [email protected]
IRD Registration No: 123456789
Professional License No: OPT-SL-9876
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 07, 2023
Service Location: Colombo, Sri Lanka
Bill To:
Mr. Arjuna Perera
42/1A, Nawala Road, Nugegoda
Colombo 07, Sri Lanka
NIC No: 1985XXXXXV
Phone: +94 77 123 4567
Payment Information:
Bank: Commercial Bank of Ceylon PLC
Branch: Colombo Fort Main Branch
Account Name: Colombo Vision Care (Pvt) Ltd
Account Number: 1234-5678-9012-3456
Currency: Sri Lankan Rupees (LKR)
| # | Description of Optometry Services & Goods | Qty | Unit Price (LKR) | Total Amount (LKR) |
|---|---|---|---|---|
| 1 |
Comprehensive Eye Examination Includes visual acuity testing, refraction, tonometry (eye pressure), and dilated fundus examination performed by a licensed Optometrist in Colombo. |
1 | 4,500.00 | 4,500.00 |
| 2 |
Premium Anti-Reflective Lenses High-index 1.67 lenses with blue light filter and anti-scratch coating. Prescription verified by our Sri Lanka Colombo clinic specialists. |
2 | 12,000.00 | 24,000.00 |
| 3 |
Designer Titanium Frame Lightweight, hypoallergenic titanium frame selected during consultation. Includes adjustment and fitting service. |
1 | 18,500.00 | 18,500.00 |
| 4 |
Dry Eye Syndrome Treatment Initial consultation and prescription of preservative-free artificial tears and eyelid hygiene kit. |
1 | 3,200.00 | 3,200.00 |
| 5 |
Contact Lens Fitting & Education Trial set of daily disposable lenses and professional fitting session by certified Optometrist. |
1 | 5,800.00 | 5,800.00 |
| 6 |
Eye Health Report & Documentation Detailed medical report suitable for insurance claims or occupational health requirements in Sri Lanka. |
1 | 1,500.00 | 1,500.00 |
| Subtotal: | LKR 57,500.00 |
| Discount (5% Loyalty Member): | - LKR 2,875.00 |
| Net Amount: | LKR 54,625.00 |
| VAT (18% - Sri Lanka Govt.): | LKR 9,832.50 |
| GRAND TOTAL: | LKR 64,457.50 |
Terms and Conditions:
- This invoice is issued by Colombo Vision Care & Optometry, a registered healthcare provider in Sri Lanka Colombo.
- Payment is due within 14 days of the invoice date. Late payments may incur a 2% monthly interest charge.
- All optical goods are subject to a 30-day warranty against manufacturing defects. This warranty does not cover damage due to misuse or accidents.
- Eye examination results are valid for 12 months. Please schedule your next appointment with our Optometrist team accordingly.
- VAT is calculated in accordance with the Inland Revenue Department of Sri Lanka regulations.
- For any disputes regarding this invoice, please contact our billing department within 7 days of receipt.
- Prescription lenses are made to order and cannot be returned unless there is a verified error in manufacturing.
- Our clinic adheres to the highest standards of optometric care as recognized by the Optometrists Association of Sri Lanka.
Additional Notes:
Thank you for choosing Colombo Vision Care & Optometry for your eye health needs. We are committed to providing exceptional optical services across Sri Lanka Colombo and surrounding areas. Your vision is our priority, and we appreciate your trust in our professional Optometrist team.
Please retain this invoice for your records and for any insurance reimbursement claims. If you require a duplicate copy, please contact us with your invoice number.
Authorized Signature:
Dr. Nimali FernandoLead Optometrist
Colombo Vision Care & Optometry ⬇️ Download as DOCX Edit online as DOCX
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