Invoice Optometrist in Uganda Kampala –Free Word Template Download with AI
Address: Plot 45, Acacia Avenue, Kololo Hill
City: Kampala, Uganda
Phone: +256 700 123 456
Email: [email protected]
TIN: URA-987654321
License No: UMO-2023-0045
Invoice #: INV-UG-2023-0892
Date: October 24, 2023
Due Date: November 07, 2023
Status: PENDING
Bill To:
Mr. James Okello
Director, Okello Trading Ltd.
Plot 12, Jinja Road
Kampala, Uganda
Email: [email protected]
Service Location:
Kampala Vision Care Clinic
Consultation Room B
Kololo, Kampala
Uganda
| # | Description of Optometry Services | Quantity | Unit Price (UGX) | Total (UGX) |
|---|---|---|---|---|
| 1 |
Comprehensive Eye Examination Includes visual acuity test, refraction, eye health assessment, and intraocular pressure measurement performed by a licensed Optometrist in Kampala. |
1 | 150,000 | 150,000 |
| 2 |
Premium Anti-Reflective Lenses High-index 1.67 lenses with blue light filter coating. Custom ground for prescription. |
2 | 350,000 | 700,000 |
| 3 |
Titanium Eyeglass Frames Model: KV-Titanium-04. Lightweight, durable frames sourced for the Ugandan market. |
1 | 450,000 | 450,000 |
| 4 |
Dry Eye Treatment Consultation Specialized assessment and initial treatment plan for dry eye syndrome. |
1 | 100,000 | 100,000 |
| 5 |
Lubricating Eye Drops (Prescription) 30ml bottle of preservative-free artificial tears. |
2 | 45,000 | 90,000 |
| 6 |
Protective Eyeglass Case & Cleaning Kit Hard-shell case and microfiber cleaning cloth. |
1 | 30,000 | 30,000 |
Amount in words: One Million, Seven Hundred Forty-Three Thousand, Six Hundred Uganda Shillings.
Important Notes:- This invoice is issued in accordance with the tax regulations of the Uganda Revenue Authority (URA).
- Please retain this document for your records and insurance claims.
- Payment is due within 14 days of the invoice date.
- For any discrepancies regarding the optometry services rendered, please contact our billing department immediately.
- Our clinic is committed to providing the highest standard of eye care in Kampala, Uganda.
Payment Methods Accepted:
Bank Transfer:
Bank: Stanbic Bank Uganda Ltd.
Account Name: Kampala Vision Care Optometrists Ltd.
Account Number: 1234567890
Branch: Kampala Road Branch
Mobile Money:
MTN MoMo: +256 700 123 456
Airtel Money: +256 780 987 654
Cash:
Accepted at our Kampala clinic during business hours.
Authorized SignatureDr. Sarah Nalubega, Optometrist Received By
Client Signature ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT