Invoice Paramedic in Thailand Bangkok –Free Word Template Download with AI
123 Sukhumvit Road, Khlong Toei Nuea
Watthana District, Thailand Bangkok 10110
Tax ID: 0105559000123
Phone: +66 2 123 4567 | Email: [email protected]
Invoice Number: INV-BKK-2023-8942
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Payment Status: Pending
Bill To:
Mr. John Smith
456 Silom Road, Bang Rak
Thailand Bangkok 10500
Phone: +66 89 123 4567
Email: [email protected]
Service Details:
Date of Service: October 20, 2023
Time of Dispatch: 14:30 HRS
Location: Central World, Pathum Wan, Thailand Bangkok
Service Type: Private Paramedic Transport
| Description of Services | Quantity | Unit Price (THB) | Total (THB) |
|---|---|---|---|
|
Emergency Paramedic Response Fee Dispatch of certified paramedic unit within Thailand Bangkok metropolitan area. Includes initial assessment and stabilization. |
1 | 2,500.00 | 2,500.00 |
|
Advanced Life Support (ALS) Paramedic Care On-site advanced medical intervention by licensed paramedic personnel. Includes cardiac monitoring, IV therapy, and medication administration. |
1 | 4,000.00 | 4,000.00 |
|
Ambulance Transport within Thailand Bangkok Transportation from incident site to Bumrungrad International Hospital. Distance: 12km. Includes toll fees within Thailand Bangkok expressways. |
1 | 3,500.00 | 3,500.00 |
|
Oxygen Therapy & Medical Equipment Usage of portable oxygen concentrator and suction devices operated by the paramedic team during transit. |
1 | 1,200.00 | 1,200.00 |
|
Medical Documentation & Reporting Comprehensive patient care report (PCR) generated by the attending paramedic for hospital handover and insurance purposes. |
1 | 800.00 | 800.00 |
Terms and Conditions for Paramedic Services in Thailand Bangkok
1. Payment Terms: Payment is due within 30 days of the invoice date. Late payments will incur a penalty of 1.5% per month.
2. Service Scope: This invoice covers the specific paramedic services rendered on the date specified. Any additional medical supplies or extended transport times outside the standard Thailand Bangkok zone will be billed separately.
3. Licensing: All paramedic staff employed by Capital City Emergency Medical Services are fully licensed and certified by the Ministry of Public Health of Thailand.
4. Insurance: If this service was covered by insurance, please submit this invoice along with the medical report to your provider. We accept direct payments from major international insurance companies operating in Thailand Bangkok.
5. Disputes: Any discrepancies regarding this invoice must be reported within 14 days of receipt. Please contact our billing department with your invoice number.
6. Privacy: Patient information is handled in strict accordance with Thai medical privacy laws. This invoice contains minimal personal data necessary for billing.
7. Bank Transfer Details:
Bank Name: Bangkok Bank
Account Name: Capital City Emergency Medical Services Co., Ltd.
Account Number: 123-4-56789-0
SWIFT Code: BKKBTHBK
Authorized Signature
Dr. Somchai Jirapong
Medical Director
Received By
__________________________
Date: ____________________
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