Invoice Psychiatrist in India New Delhi –Free Word Template Download with AI

Bill To:

Mr. Rajesh Verma

15, Green Park Extension

New Delhi, Delhi 110016

India

Patient ID: DMW-2023-8842

Invoice Details:

Invoice Number: INV-2023-10-045

Date of Issue: October 24, 2023

Due Date: November 07, 2023

Service Period: October 01, 2023 - October 23, 2023

Description of Services Rendered

This invoice details the professional psychiatric consultation and therapeutic services provided by Dr. Ananya Sharma at the Delhi Mind & Wellness Clinic, located in New Delhi, India. The services include clinical assessment, cognitive behavioral therapy (CBT), and medication management as per the treatment plan agreed upon.

#	Description of Service	Date	Qty	Amount (INR)
1	Initial Psychiatric Evaluation & Diagnosis Comprehensive clinical interview, history taking, and diagnostic assessment conducted at the New Delhi clinic.	Oct 02, 2023	1	₹ 3,500.00
2	Individual Psychotherapy Session (CBT) One-on-one Cognitive Behavioral Therapy session focusing on anxiety management and coping strategies.	Oct 05, 2023	1	₹ 2,500.00
3	Individual Psychotherapy Session (CBT) Follow-up therapy session to review progress and adjust therapeutic interventions.	Oct 12, 2023	1	₹ 2,500.00
4	Medication Review & Management Consultation Review of current pharmacological treatment, side effect monitoring, and prescription adjustment.	Oct 19, 2023	1	₹ 1,500.00
5	Psychiatric Report for Insurance/Employer Formal medical report detailing diagnosis and treatment plan for submission to insurance provider or employer in India.	Oct 20, 2023	1	₹ 1,000.00

Subtotal: ₹ 11,000.00 GST (18%): ₹ 1,980.00 Discount (Early Bird): - ₹ 500.00 Total Due: ₹ 12,480.00 Payment Instructions

Please make the payment within 14 days of the invoice date. Payments can be made via bank transfer, UPI, or credit card. Please quote the Invoice Number (INV-2023-10-045) as the reference.

Bank Transfer Details:
Bank Name: HDFC Bank
Branch: Hauz Khas, New Delhi
Account Name: Dr. Ananya Sharma
Account Number: 50200012345678
IFSC Code: HDFC0001234
UPI ID: dr.ananya@hdfcbank

Terms and Conditions:

This invoice is issued in accordance with the Goods and Services Tax (GST) laws of India.
Late payments may incur a penalty of 2% per month on the outstanding amount.
All medical records and reports remain the property of Delhi Mind & Wellness Clinic.
Confidentiality of patient information is maintained as per the Indian Medical Council (Professional Conduct, Etiquette and Ethics) Regulations.
Disputes regarding this invoice shall be subject to the jurisdiction of courts in New Delhi, India.

Important Notes:

Thank you for trusting Dr. Ananya Sharma with your mental health care. This invoice covers the professional fees for psychiatric services rendered. It does not include costs for medications purchased from external pharmacies or third-party diagnostic tests unless explicitly stated. Please retain this document for your records and insurance claims.

Authorized Signature

Dr. Ananya Sharma

Proprietor

Received By

____________________

Date: _______________

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