Invoice Physiotherapist in Ethiopia Addis Ababa –Free Word Template Download with AI
Professional Physiotherapist Services in Ethiopia
Bole Subcity, Woreda 03, House No. 456
Addis Ababa, Ethiopia
Tel: +251-11-618-XXXX | Email: [email protected]
TIN: 10023456789
Invoice Number: AP-2024-0892
Date Issued: October 15, 2024
Due Date: October 30, 2024
Payment Status: Pending
Bill To:
Client Name: Abebe Kebede
Address: Kirkos Subcity, Woreda 07, House No. 123
City: Addis Ababa, Ethiopia
Phone: +251-911-XXX-XXX
Email: [email protected]
Insurance Provider: Nyala Insurance (Policy #NYL-789456)
| # | Description of Physiotherapy Services | Date | Qty | Unit Price (ETB) | Total (ETB) |
|---|---|---|---|---|---|
| 1 | Initial Comprehensive Assessment & Diagnosis by Licensed Physiotherapist | Oct 01, 2024 | 1 | 1,500.00 | 1,500.00 |
| 2 | Manual Therapy for Lower Back Pain (Spinal Manipulation) | Oct 03, 2024 | 3 | 1,200.00 | 3,600.00 |
| 3 | Therapeutic Exercise Program (Core Strengthening) | Oct 05, 2024 | 4 | 900.00 | 3,600.00 |
| 4 | Electrotherapy (TENS) for Pain Management | Oct 08, 2024 | 2 | 800.00 | 1,600.00 |
| 5 | Ultrasound Therapy for Soft Tissue Healing | Oct 10, 2024 | 2 | 1,000.00 | 2,000.00 |
| 6 | Postural Correction Training & Ergonomic Advice | Oct 12, 2024 | 1 | 700.00 | 700.00 |
| 7 | Follow-up Assessment & Progress Evaluation | Oct 15, 2024 | 1 | 1,000.00 | 1,000.00 |
| Subtotal: | 14,000.00 ETB |
| VAT (15%): | 2,100.00 ETB |
| Total Amount Due: | 16,100.00 ETB |
Payment Instructions:
Please make payment within 15 days of the invoice date. Late payments may incur a 2% monthly interest charge.
Bank Transfer:
Bank Name: Commercial Bank of Ethiopia
Branch: Bole Branch
Account Name: Addis Physiotherapy & Rehabilitation Center
Account Number: 1000XXXXXXX
Cash Payment: Accepted at our clinic in Addis Ababa, Ethiopia.
Mobile Payment: Telebirr / CBE Birr accepted.
Terms and Conditions:
1. This invoice is issued in accordance with the tax regulations of Ethiopia.
2. All physiotherapy services are provided by licensed professionals registered with the Ethiopian Medical Association.
3. Insurance claims should be submitted with this invoice and supporting medical reports.
4. Please retain this document for your records and tax purposes.
5. Any disputes regarding this invoice must be raised within 30 days of issuance.
6. Services are rendered at our facility in Addis Ababa, Ethiopia, unless otherwise specified.
Authorized Signature:
Dr. Selamawit Tadesse
Lead Physiotherapist
Addis Physiotherapy & Rehabilitation Center
Client Acknowledgment:
Signature: ___________________
Date: ___________________
Thank you for choosing Addis Physiotherapy & Rehabilitation Center.
Your health and recovery are our priority in Addis Ababa, Ethiopia.
For inquiries, contact us at +251-11-618-XXXX or visit our clinic.
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