Invoice Orthodontist in Egypt Cairo –Free Word Template Download with AI
Dr. Ahmed Hassan, DDS, MS Orthodontics
15 El-Tahrir Street, Downtown Cairo, Egypt
Tel: +20 2 2574 8899 | Email: [email protected]
Tax ID: 123-456-789000
Invoice Number: INV-2023-10-045
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Payment Status: Pending
Bill To:Patient Name: Sarah Mohamed Ali
Address: 42 Zamalek Street, Zamalek, Giza, Cairo, Egypt
Phone: +20 10 1234 5678
Email: [email protected]
National ID: 29801234567890
Insurance Provider: Bupa Egypt (Policy #BU-987654)
Description of Orthodontic Services RenderedThis invoice details the professional orthodontic treatment provided at our clinic in Cairo, Egypt. The services include comprehensive diagnosis, treatment planning, appliance placement, and follow-up care as per the agreed treatment plan. All procedures adhere to the standards set by the Egyptian Dental Syndicate.
| # | Service Description | Date | Qty | Unit Price (EGP) | Total (EGP) |
|---|---|---|---|---|---|
| 1 | Initial Orthodontic Consultation & Comprehensive Examination | 2023-09-01 | 1 | 1,500.00 | 1,500.00 |
| 2 | Diagnostic Records: Panoramic X-Ray, Cephalometric X-Ray, and Study Models | 2023-09-01 | 1 | 2,200.00 | 2,200.00 |
| 3 | Customized Orthodontic Treatment Plan Development | 2023-09-05 | 1 | 1,000.00 | 1,000.00 |
| 4 | Placement of Fixed Metal Braces (Full Arch - Upper & Lower) | 2023-09-15 | 1 | 18,000.00 | 18,000.00 |
| 5 | Orthodontic Adjustment & Progress Monitoring (Session 1) | 2023-10-01 | 1 | 1,200.00 | 1,200.00 |
| 6 | Orthodontic Adjustment & Progress Monitoring (Session 2) | 2023-10-15 | 1 | 1,200.00 | 1,200.00 |
| 7 | Emergency Visit: Bracket Repair & Wire Adjustment | 2023-10-20 | 1 | 800.00 | 800.00 |
| 8 | Professional Oral Hygiene Instruction for Orthodontic Patients | 2023-09-15 | 1 | 500.00 | 500.00 |
Payment Terms & Conditions:
1. Payment is due within 30 days from the date of this invoice. Late payments may incur a 2% monthly interest charge.
2. Accepted payment methods include cash (Egyptian Pounds), bank transfer, credit/debit cards, and mobile wallets (Vodafone Cash, Orange Cash).
3. For bank transfers, please use the following details:
Bank Name: National Bank of Egypt
Branch: Downtown Cairo
Account Name: Cairo Elite Orthodontics
Account Number: 1234567890123456
IBAN: EG12 3456 7890 1234 5678 9012 345
4. This invoice is valid for tax purposes in Egypt. Please retain it for your records.
5. Any disputes regarding this invoice must be raised within 15 days of receipt.
6. Future orthodontic appointments are scheduled as follows: Next adjustment on November 1, 2023. Please confirm attendance.
7. Thank you for choosing Cairo Elite Orthodontics for your dental care needs in Egypt. We are committed to providing the highest quality orthodontic treatment in Cairo.
Authorized Signature
Dr. Ahmed Hassan
Lead Orthodontist
Patient Acknowledgment
Sarah Mohamed Ali
Date: _______________
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