Invoice Optometrist in Vietnam Ho Chi Minh City –Free Word Template Download with AI

Bill To:

Mr. Nguyen Van A

45 Le Loi Street, Ward 1

District 1, Ho Chi Minh City, Vietnam

Phone: +84 90 123 4567

Payment Information:

Bank Name: Vietcombank

Branch: Nguyen Hue Branch, HCMC

Account Name: Saigon Vision Optometry Center

Account Number: 0071001234567

Reference: INV-2023-10-045

#	Description of Optometry Services	Qty	Unit Price (VND)	Total (VND)
1	Comprehensive Eye Examination Includes visual acuity test, refraction, tonometry (eye pressure), and dilated fundus examination performed by a licensed Optometrist in Ho Chi Minh City.	1	1,500,000	1,500,000
2	Premium Anti-Reflective Lenses (Pair) High-index 1.67 lenses with blue light filter and scratch resistance, customized for prescription.	1	3,200,000	3,200,000
3	Titanium Optical Frame Model: TV-8802. Lightweight, hypoallergenic titanium frame selected during consultation.	1	2,800,000	2,800,000
4	Optical Dispensing & Adjustment Precision lens edging, frame fitting, and final adjustment by certified optician.	1	500,000	500,000
5	Dry Eye Treatment Session Lipiflow thermal pulsation therapy administered by specialist Optometrist.	1	2,000,000	2,000,000

Subtotal: 10,000,000 VND VAT (10%): 1,000,000 VND Discount (Member): -500,000 VND TOTAL AMOUNT DUE: 10,500,000 VND

Amount in words: Ten million five hundred thousand Vietnamese Dong only.

Terms, Conditions, and Important Notes:

Payment Terms: Payment is due within 14 days of the invoice date. Late payments may incur a 2% monthly interest fee.
Validity: This invoice is valid for tax purposes in Vietnam and complies with the General Department of Taxation regulations.
Warranty: All optical frames and lenses purchased from Saigon Vision Optometry Center come with a 12-month warranty against manufacturing defects. This warranty does not cover damage caused by misuse or accidents.
Follow-up: A complimentary follow-up eye check-up is included within 30 days of this service to ensure optimal vision correction.
Disputes: Any discrepancies regarding this invoice must be reported within 7 days of receipt. Please contact our billing department in Ho Chi Minh City.
Privacy: Your personal health information is protected under Vietnamese law and our strict privacy policy.

Authorized by:

Dr. Tran Thi B
Lead Optometrist
Saigon Vision Optometry Center

Received by:

(Client Signature)
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX

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