Invoice Optometrist in Thailand Bangkok –Free Word Template Download with AI
123 Sukhumvit Road, Khlong Toei Nuea
Watthana District, Bangkok 10110, Thailand
Tel: +66 2 123 4567 | Email: [email protected]
VAT Registration No.: 010555123456789
Invoice Number: INV-BKK-2023-0892
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Payment Terms: Net 30 Days
Bill To:
Somchai Jitmuangnon
456 Phahonyothin Road, Chatuchak
Bangkok 10900, Thailand
ID/Tax No.: 1-1234-56789-01-2
Email: [email protected]
Service Location:
Bangkok Vision Care Clinic
Room 402, Siam Paragon Medical Center
Ram Intra Road, Pathum Wan
Bangkok 10330, Thailand
| # | Description of Optometry Services | Quantity | Unit Price (THB) | Total (THB) |
|---|---|---|---|---|
| 1 |
Comprehensive Eye Examination Includes visual acuity testing, refraction, tonometry (eye pressure), and retinal imaging. Performed by a licensed Optometrist in Bangkok. |
1 | 2,500.00 | 2,500.00 |
| 2 |
Premium Anti-Reflective Lenses High-index 1.67 lenses with blue light filter and scratch resistance. Custom ground for prescription accuracy. |
1 Pair | 8,500.00 | 8,500.00 |
| 3 |
Designer Titanium Frame Lightweight, hypoallergenic titanium frame. Includes adjustment and fitting service. |
1 | 4,200.00 | 4,200.00 |
| 4 |
Dry Eye Treatment Session Intense Pulsed Light (IPL) therapy session for Meibomian Gland Dysfunction. |
1 | 3,000.00 | 3,000.00 |
| 5 |
Prescription Contact Lens Fitting Includes trial lenses, corneal topography mapping, and follow-up consultation. |
1 | 1,800.00 | 1,800.00 |
| 6 |
Monthly Supply of Toric Contact Lenses Brand: Acuvue Oasys for Astigmatism. Box of 6 lenses. |
2 Boxes | 1,250.00 | 2,500.00 |
Payment Instructions & Terms
Bank Transfer Details:
Bank: Kasikorn Bank (KBank)
Account Name: Bangkok Vision Care Co., Ltd.
Account Number: 123-4-56789-0
SWIFT Code: KASITHBK
Please reference Invoice Number INV-BKK-2023-0892 in your transfer description.
Important Notes:
1. This invoice is valid for payment within 30 days from the date of issue. Late payments may incur a 1.5% monthly interest charge.
2. All optical goods sold are subject to a 14-day return policy for manufacturing defects only. Prescription lenses are non-returnable unless there is a verified error in the prescription.
3. This document serves as an official receipt for tax purposes in Thailand. Please retain this invoice for your records.
4. Our Optometrist team is available for follow-up consultations regarding your eye health and new prescription.
Authorized Signature:
Dr. Ananya Srisawat, O.D.
Lead Optometrist
Received By:
__________________________
Date: ____________________
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