Invoice Orthodontist in Kazakhstan Almaty –Free Word Template Download with AI

Bill To:

Mr. Arman K.

Residential Address: Abai Avenue, 45, Apt 12

Almaty, Kazakhstan

ID Number (ADN): 980101200001

Phone: +7 (777) 987-65-43

Invoice Number: INV-2023-8942

Date of Issue: October 24, 2023

Due Date: November 07, 2023

Service Period: Phase 1 Treatment (Q4 2023)

This invoice represents the formal request for payment regarding the comprehensive orthodontic treatment plan executed at our clinic in Almaty, Kazakhstan. As a leading provider of dental alignment and jaw correction services in the region, Almaty Elite Orthodontics is committed to delivering world-class care. The following items detail the specific procedures, materials, and professional consultations rendered to the patient listed above.

#	Description of Orthodontic Service	Quantity	Unit Price (KZT)	Total (KZT)
1	Initial Comprehensive Orthodontic Consultation Includes panoramic X-ray analysis, digital smile design assessment, and formulation of the treatment roadmap.	1	15,000	15,000
2	Preventive Dental Hygiene & Scaling Mandatory preparation of the oral cavity prior to the installation of orthodontic appliances to ensure optimal bonding and gum health.	1	12,000	12,000
3	Installation of Self-Ligating Metal Brackets (Full Arch) Supply and application of premium-grade self-ligating brackets for both upper and lower jaws. This technology reduces friction and shortens treatment time.	1	350,000	350,000
4	Custom Orthodontic Archwires (Set 1) Initial series of nickel-titanium and stainless steel wires tailored to the patient's specific dental arch dimensions.	1	45,000	45,000
5	Interproximal Reduction (IPR) Minimal enamel reshaping to create necessary space for tooth alignment without extraction.	1	20,000	20,000
6	Monthly Adjustment & Monitoring Session Professional adjustment of wires and brackets to ensure continuous progress. Includes check-up of oral hygiene status.	3	10,000	30,000

Subtotal: 472,000 KZT VAT (12%): 56,640 KZT Discount (Early Bird): -20,000 KZT TOTAL DUE: 508,640 KZT

Payment Information

Currency: Kazakhstani Tenge (KZT)

Bank Name: Halyk Bank JSC

Account Name: Almaty Elite Orthodontics LLP

Account Number (IBAN): KZ85 125K ZT50 0123 4567 89

SWIFT Code: HLBBKZKA

Payment Reference: Please use Invoice Number INV-2023-8942 as the payment reference.

Terms, Conditions, and Patient Responsibilities

Payment Terms: Payment is due within 14 days of the invoice date. Late payments may incur a penalty fee of 0.5% per day as per the regulations of Kazakhstan.
Treatment Continuity: Regular attendance at monthly adjustment appointments is crucial for the success of the orthodontic treatment. Failure to attend scheduled appointments may result in delays and additional costs.
Dietary Restrictions: Patients are advised to avoid hard, sticky, or chewy foods that may damage the orthodontic appliances. Damage caused by negligence may be billed separately.
Hygiene: Maintaining excellent oral hygiene is the patient's responsibility. Neglect may lead to decalcification or gum disease, which could interrupt the orthodontic process.
Emergency Care: In case of bracket detachment or wire poking, please contact our Almaty clinic immediately. Emergency repairs are subject to availability and may incur a small fee if outside scheduled hours.
Validity: This invoice is valid for 30 days from the date of issue. Prices are subject to change after this period.
Legal Compliance: This document complies with the tax and invoicing regulations of the Republic of Kazakhstan. A copy of this invoice should be kept for your personal records.

Thank you for choosing Almaty Elite Orthodontics. We are dedicated to helping you achieve a healthy, confident smile through advanced orthodontic care in the heart of Almaty.

Authorized Signature

Dr. Elena V. (Chief Orthodontist)

Almaty Elite Orthodontics

Received By

__________________________

Date: ____________________

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