Invoice Psychiatrist in Pakistan Karachi –Free Word Template Download with AI
Consultant Psychiatrist
Shaheed Mohtarma Benazir Bhutto Hospital
Clifton, Karachi, Sindh, Pakistan
Phone: +92-21-3584XXXX | Email: [email protected]
Invoice #: INV-2024-0876
Date: October 15, 2024
Due Date: October 30, 2024
Bill To:Patient Name: Mr. Ahmed Raza
Address: House #45, Street #7, DHA Phase 5
City: Karachi, Sindh, Pakistan
Phone: +92-300-1234567
Insurance Provider: Al-Meezan General Insurance
Policy Number: PSI-789456123
Group ID: GRP-KHI-2024
Referring Physician: Dr. Bilal Ahmed, General Practitioner
Description of Services Rendered:| Service Description | ICD-10 Code | Date of Service | Quantity | Unit Price (PKR) | Total (PKR) |
|---|---|---|---|---|---|
| Initial psychiatric evaluation and diagnostic assessment for anxiety disorder | F41.1 | October 10, 2024 | 1 | 8,500 | 8,500 |
| Follow-up consultation for medication management and therapy progress review | F41.1 | October 12, 2024 | 1 | 5,000 | 5,000 |
| Cognitive Behavioral Therapy (CBT) session - 60 minutes | F41.1 | October 14, 2024 | 1 | 6,000 | 6,000 |
| Psychological testing and interpretation (Beck Anxiety Inventory) | F41.1 | October 10, 2024 | 1 | 3,500 | 3,500 |
| Prescription of psychotropic medication (Sertraline 50mg) | F41.1 | October 10, 2024 | 1 | 1,200 | 1,200 |
Subtotal: PKR 24,200
Discount (Insurance Coverage): -PKR 12,100
Patient Responsibility: PKR 12,100
Total Amount Due: PKR 12,100
Payment Instructions:Please make payment within 15 days of the invoice date. Payments can be made via:
- Bank Transfer: Meezan Bank, Account Title: Dr. Ayesha Khan, Account Number: 0123456789012, IBAN: PK36MEZN0000001234567890
- Cash: At the clinic reception during office hours
- Online Payment: Through the clinic’s secure payment portal at www.psychiatrykarachi.pk/pay
For any inquiries regarding this invoice, please contact our billing department at [email protected] or call +92-21-3584XXXX.
Important Notes:This invoice is issued in accordance with the regulations of the Pakistan Medical and Dental Council (PMDC) and the Sindh Healthcare Commission. All services provided are confidential and adhere to the ethical standards of psychiatric practice in Pakistan. The patient’s information is protected under the Data Protection Act of Pakistan. If you have any questions about your treatment or this invoice, please do not hesitate to contact us. Your mental health is our priority, and we are committed to providing you with the highest quality psychiatric care in Karachi.
Authorized Signature:
Dr. Ayesha KhanDate:
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