Invoice Optometrist in Sudan Khartoum –Free Word Template Download with AI
Professional Eye Care Services
Plot 45, Al-Amal Street, Bahri District
Khartoum, Sudan
Tel: +249 183 123 456 | Email: [email protected]
TIN: 100234567890
Invoice Number: INV-2023-0892
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Payment Status: Pending
Bill To:
Mr. Ahmed Hassan Ibrahim
Resident of Khartoum North
Al-Riyadh Street, Block 12, Apt 4
Khartoum, Sudan
ID Number: 1001985XXXXXX
Service Details:
Service Date: October 24, 2023
Attending Optometrist: Dr. Fatima Al-Zubair
License No: OPT-KRT-445
Department: Clinical Optometry & Vision Therapy
| # | Description of Services / Goods | Quantity | Unit Price (SDG) | Total (SDG) |
|---|---|---|---|---|
| 1 |
Comprehensive Eye Examination Includes visual acuity testing, refraction, intraocular pressure measurement, and binocular vision assessment performed by a licensed Optometrist in Khartoum. |
1 | 15,000.00 | 15,000.00 |
| 2 |
Dilated Fundus Examination Retinal health screening using mydriatic drops to assess the optic nerve and retina for signs of diabetes or hypertension. |
1 | 8,000.00 | 8,000.00 |
| 3 |
Prescription Eyeglass Lenses (Bifocal) High-index anti-reflective coated lenses, customized prescription for distance and near vision. |
1 Pair | 45,000.00 | 45,000.00 |
| 4 |
Designer Eyeglass Frames Model: Titan Flex Series, Color: Matte Black. Includes adjustment and fitting service. |
1 | 30,000.00 | 30,000.00 |
| 5 |
Specialized Eye Drops Post-examination lubricating and anti-inflammatory drops as prescribed by the Optometrist. |
2 | 3,500.00 | 7,000.00 |
| 6 |
Certified Vision Report Official medical document detailing refractive error and ocular health status, valid for school or work requirements in Sudan. |
1 | 2,000.00 | 2,000.00 |
| Subtotal: | 107,000.00 SDG |
| VAT (15%): | 16,050.00 SDG |
| Discount (Loyalty Member): | -5,000.00 SDG |
| Grand Total: | 118,050.00 SDG |
Payment Instructions & Terms
Payment is due within 30 days of the invoice date. Please make payments in Sudanese Pounds (SDG). We accept cash payments at our Khartoum clinic, bank transfers, or mobile money services.
Bank Transfer Details:
Bank Name: Bank of Khartoum
Account Name: Nile Valley Optometry Center
Account Number: 1001234567890
Branch: Bahri Main Branch
Late payments may incur a penalty fee of 2% per month. Please quote the Invoice Number (INV-2023-0892) when making any payment.
Clinical Notes & Warranty
This invoice covers the professional services rendered by our licensed Optometrist team. The prescription provided is valid for one year from the date of examination. Please return for a follow-up appointment if you experience any discomfort with your new eyewear within the first 14 days.
Warranty: Our frames come with a 6-month warranty against manufacturing defects. Lenses are guaranteed against coating peeling for 12 months. This warranty is valid only within Sudan and requires this original invoice for verification.
Thank you for trusting Nile Valley Optometry Center for your eye care needs in Khartoum. We are committed to providing the highest standard of vision care in Sudan.
Authorized Signature
Dr. Fatima Al-Zubair
Lead Optometrist
Received By
Mr. Ahmed Hassan Ibrahim
Date: _______________
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