Invoice Psychiatrist in India Bangalore –Free Word Template Download with AI
MBBS, MD (Psychiatry), DNB (Psychiatry)
Senior Consultant Psychiatrist
MindCare Wellness Clinic
123, MG Road, Indiranagar
Bangalore, Karnataka 560038
India
Phone: +91 80 1234 5678
Email: [email protected]
GSTIN: 29ABCDE1234F1Z5
Invoice Number: INV-2024-0456
Date: January 15, 2024
Due Date: January 30, 2024
Payment Terms: Net 15 Days
Billed To:
Mr. Rajesh Kumar
456, Koramangala 4th Block
Bangalore, Karnataka 560034
India
Phone: +91 98765 43210
Email: [email protected]
Patient ID: MCW-2024-0123
| Description of Services | Date of Service | Quantity | Rate (INR) | Amount (INR) |
|---|---|---|---|---|
| Initial Psychiatric Consultation - Comprehensive evaluation including clinical interview, mental status examination, and diagnostic assessment for anxiety and depressive disorders | January 10, 2024 | 1 | 2,500.00 | 2,500.00 |
| Follow-up Psychiatric Session - Medication review, symptom monitoring, and treatment plan adjustment for ongoing management of mood disorder | January 12, 2024 | 1 | 1,800.00 | 1,800.00 |
| Psychiatric Assessment Report - Detailed clinical documentation including diagnosis, treatment recommendations, and progress notes for insurance and medical records | January 13, 2024 | 1 | 1,500.00 | 1,500.00 |
| Psychopharmacology Management - Prescription and monitoring of antidepressant medication with dosage optimization and side effect management consultation | January 14, 2024 | 1 | 1,200.00 | 1,200.00 |
| Family Counseling Session - Psychoeducation and therapeutic guidance for family members regarding patient's mental health condition and support strategies | January 14, 2024 | 1 | 2,000.00 | 2,000.00 |
Subtotal: INR 9,000.00
GST (18%): INR 1,620.00
Total Amount Due: INR 10,620.00
Payment Information
Bank Name: State Bank of India
Branch: Indiranagar Branch, Bangalore
Account Name: Dr. Priya Sharma
Account Number: 30582467190
IFSC Code: SBIN0012345
UPI ID: drpriya.sharma@upi
Cheque Payable To: Dr. Priya Sharma
Please mention Invoice Number INV-2024-0456 as payment reference.
Important Notes
This invoice is issued in accordance with the Goods and Services Tax (GST) regulations of India. All psychiatric services rendered at MindCare Wellness Clinic in Bangalore are subject to 18% GST as per current Indian tax laws.
Payment is due within 15 days from the date of invoice. Late payments may incur a penalty of 2% per month on the outstanding amount.
All psychiatric consultations and treatments are conducted in strict confidentiality as per the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations and applicable data protection laws.
This invoice covers professional psychiatric services only. Medication costs, laboratory tests, and third-party services are billed separately.
For any queries regarding this invoice or your psychiatric treatment plan, please contact our clinic in Bangalore during working hours (Monday to Saturday, 9:00 AM to 7:00 PM).
Thank you for trusting Dr. Priya Sharma and MindCare Wellness Clinic for your mental health care needs in Bangalore, India.
Authorized Signature:
Dr. Priya Sharma
Senior Consultant Psychiatrist
MindCare Wellness Clinic, Bangalore
Medical Council Registration No: KMC-12345
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