Invoice Physiotherapist in Nepal Kathmandu –Free Word Template Download with AI
Address: 123 Durbar Marg, Lazimpat, Kathmandu, Nepal
Phone: +977-1-4445566 | Mobile: +977-9841000000
Email: [email protected]
PAN/VAT No: 123456789
License No: MOHP/KTM/PT/2080/001
Invoice #: INV-2024-0892
Date: 2024-10-25
Due Date: 2024-11-05
Payment Status: Pending
Bill To:
Patient Name: Mr. Rajesh Sharma
Address: Flat 4B, Thamel Guest House, Thamel, Kathmandu, Nepal
Phone: +977-9801234567
Email: [email protected]
Insurance Provider: Nepal Life Insurance Co. Ltd.
Policy Number: NLI-PT-998877
| Description of Physiotherapy Services | Quantity | Unit Price (NPR) | Total (NPR) |
|---|---|---|---|
|
Initial Comprehensive Assessment Detailed evaluation of musculoskeletal condition, posture analysis, and functional movement screening conducted at our Kathmandu clinic. |
1 | 2,500.00 | 2,500.00 |
|
Manual Therapy Session (60 mins) Soft tissue mobilization, joint manipulation, and myofascial release techniques performed by licensed physiotherapist. |
5 | 1,800.00 | 9,000.00 |
|
Therapeutic Exercise Program Supervised strengthening and flexibility exercises tailored for lumbar spine stability and core conditioning. |
5 | 1,200.00 | 6,000.00 |
|
Electrotherapy (TENS/Interferential) Pain management using transcutaneous electrical nerve stimulation and interferential current therapy. |
5 | 800.00 | 4,000.00 |
|
Ultrasound Therapy Deep heat therapy to promote tissue healing and reduce inflammation in affected areas. |
3 | 700.00 | 2,100.00 |
|
Postural Education & Ergonomic Advice Consultation on workplace ergonomics and daily activity modifications to prevent recurrence. |
1 | 1,000.00 | 1,000.00 |
|
Home Exercise Program Documentation Customized printed guide with illustrations for continued self-management at home. |
1 | 500.00 | 500.00 |
Important Notes & Payment Instructions:
This invoice represents professional physiotherapy services rendered at our facility in Kathmandu, Nepal. All treatments were performed by qualified physiotherapists registered with the Nepal Physiotherapy Association. Payment is due within 10 days of the invoice date. Late payments may incur a 2% monthly interest charge.
Payment Methods Accepted:
- Bank Transfer: Nabil Bank Ltd., Lazimpat Branch, Account No: 0123456789
- E-Sewa: 9841000000
- Khalti: 9841000000
- Cash: Accepted at our Kathmandu clinic office during business hours (9:00 AM - 6:00 PM, Mon-Sat)
For insurance claims, please submit this invoice along with the treatment summary and referral letter to your insurance provider. Our billing department can assist with direct billing arrangements for approved policies.
If you have any questions regarding this invoice or the physiotherapy services provided, please contact our billing department at +977-1-4445566 or email [email protected]. We are committed to providing transparent and professional healthcare services to our patients in Kathmandu and throughout Nepal.
Authorized Signature
Ms. Sunita Gurung, MPT
Lead Physiotherapist
Everest Physiotherapy & Rehabilitation Center
Patient Acknowledgment
Signature: _________________________
Date: _________________________
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