Invoice Psychiatrist in China Beijing –Free Word Template Download with AI
Registered Medical Institution License No.: 11010517-11010517-A1001
Address: Room 1205, Tower B, Financial Street Center, Xicheng District, Beijing, China
Phone: +86 10 8888 9999 | Email: [email protected]
Unified Social Credit Code: 91110105MA01XXXXXK
Invoice Number: INV-BJ-2024-0876
Date of Issue: October 15, 2024
Due Date: November 15, 2024
Currency: Chinese Yuan (CNY)
Billed To:
Mr. Zhang Wei
Address: Flat 302, Building 8, Haidian District, Beijing, China
ID Number: 11010819850101XXXX
Contact: +86 138 0013 8000
Insurance Provider: Beijing Municipal Basic Medical Insurance
| Service Description | Date of Service | Quantity | Unit Price (CNY) | Total (CNY) |
|---|---|---|---|---|
| Initial Comprehensive Psychiatric Evaluation - Dr. Li Ming, Chief Psychiatrist | October 1, 2024 | 1 | 800.00 | 800.00 |
| Cognitive Behavioral Therapy Session (60 minutes) - Licensed Clinical Psychologist | October 5, 2024 | 1 | 600.00 | 600.00 |
| Psychiatric Medication Management Consultation | October 8, 2024 | 1 | 500.00 | 500.00 |
| Follow-up Psychiatric Assessment - Dr. Li Ming | October 12, 2024 | 1 | 600.00 | 600.00 |
| Psychological Testing Battery (MMPI-2, WAIS-IV) | October 3, 2024 | 1 | 1,200.00 | 1,200.00 |
| Family Therapy Session (90 minutes) | October 10, 2024 | 1 | 900.00 | 900.00 |
| Emergency Psychiatric Consultation (Weekend Service) | October 6, 2024 | 1 | 1,000.00 | 1,000.00 |
| Medical Report Preparation and Documentation | October 14, 2024 | 1 | 300.00 | 300.00 |
Important Notes and Payment Instructions:
This invoice is issued in accordance with the regulations of the National Healthcare Security Administration of China and the Beijing Municipal Health Commission. All psychiatric services rendered at Beijing MindCare Psychiatry Clinic are provided by licensed psychiatrists registered with the Chinese Medical Association.
Payment is due within 30 days of the invoice date. Please make payment via bank transfer to our designated account:
Bank Name: Bank of China, Beijing Financial Street Branch
Account Name: Beijing MindCare Psychiatry Clinic Co., Ltd.
Account Number: 345678901234567890
SWIFT Code: BKCHCNBJ900
Please reference Invoice Number INV-BJ-2024-0876 when making payment. For any questions regarding this invoice or your psychiatric care services, please contact our billing department at +86 10 8888 9999 or email [email protected].
All patient information is handled in strict confidentiality in compliance with the Personal Information Protection Law of the People's Republic of China and medical privacy regulations applicable in Beijing.
Authorized SignatureDr. Li Ming, Chief Psychiatrist
Beijing MindCare Psychiatry Clinic Patient Acknowledgment
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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