Invoice Orthodontist in South Korea Seoul –Free Word Template Download with AI
123 Gangnam-daero, Gangnam-gu, Seoul, South Korea
Tel: +82-2-555-0199 | Email: [email protected]
Business Registration No. (Juminbeon): 123-45-67890
Medical Institution License No.: 10-1234567
Invoice #: INV-2023-10-0042
Date: October 24, 2023
Due Date: November 07, 2023
Bill To (Patient)Name: Mr. James Anderson
Address: 45 Itaewon-ro, Yongsan-gu, Seoul, South Korea
Phone: +82-10-1234-5678
Email: [email protected]
Treatment ReferencePatient ID: P-88291
Treatment Plan: Comprehensive Fixed Appliance Therapy
Attending Orthodontist: Dr. Min-Ji Kim, DDS, PhD
Visit Date: October 24, 2023
Description of Orthodontic ServicesThis invoice details the professional fees for orthodontic consultation, diagnostic imaging, and the initial phase of treatment provided at our clinic in Seoul, South Korea. All procedures adhere to the standards set by the Korean Association of Orthodontists.
| Item | Description | Code | Unit Price (KRW) | Total (KRW) |
|---|---|---|---|---|
| 1 |
Initial Orthodontic Consultation Comprehensive examination of dental alignment, jaw relationship, and facial aesthetics. Discussion of treatment options including fixed braces and clear aligners. |
ORT-001 | 150,000 | 150,000 |
| 2 |
Diagnostic Imaging & Records Panoramic X-ray (OPG), Cephalometric X-ray, and 3D CBCT scan. Digital intraoral photography and study model creation for precise treatment planning in Seoul. |
ORT-005 | 250,000 | 250,000 |
| 3 |
Fixed Appliance Placement (Brackets & Bands) Bonding of high-quality ceramic brackets on upper and lower arches. Includes placement of molar bands and initial archwire insertion. |
ORT-102 | 1,200,000 | 1,200,000 |
| 4 |
Interproximal Reduction (IPR) Minimal enamel stripping to create space for alignment, performed under local anesthesia to ensure patient comfort. |
ORT-045 | 100,000 | 100,000 |
| 5 |
Orthodontic Elastics & Accessories Provision of intermaxillary elastics and power chains for the first month of treatment. |
ORT-099 | 50,000 | 50,000 |
Amount in words: One Million Seven Hundred Twenty-Five Thousand Korean Won.
Payment InformationPayment is due within 14 days of the invoice date. We accept the following payment methods common in South Korea:
- Bank Transfer: Shinhan Bank, Branch: Gangnam, Account No: 100-000-000000, Account Name: Seoul Premium Orthodontics
- Credit Card: Visa, Mastercard, Amex, and local Korean cards accepted.
- Cash: Accepted at the clinic reception.
- This invoice is issued in accordance with the Medical Service Act of South Korea.
- Prices are inclusive of VAT unless otherwise stated. The current VAT rate in South Korea is 10%.
- Any late payments may incur a penalty fee of 1.5% per month on the outstanding balance.
- Orthodontic treatment requires regular follow-up visits. Failure to attend scheduled appointments may result in additional fees or treatment delays.
- This invoice serves as a valid receipt for tax purposes and insurance claims in Seoul.
- For any discrepancies or questions regarding this invoice, please contact our billing department within 7 days.
Dr. Min-Ji Kim, DDS, PhD
Lead Orthodontist
[Official Clinic Stamp Area]
Seoul Premium Orthodontics
Gangnam-gu, Seoul, South Korea
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