Invoice Radiologist in Egypt Alexandria –Free Word Template Download with AI
Specialized Radiology & Diagnostic Services
123 El-Horreya Avenue, Smouha District
Alexandria, Egypt
Tax Registration Number (TRN): EG-123456789012345
Phone: +20 3 425 1234 | Email: [email protected]
Invoice #: INV-2023-10-045
Date: October 24, 2023
Due Date: November 24, 2023
Bill To:
Dr. Ahmed Hassan (Referring Physician)
Private Practice Clinic, Mansheya District
Alexandria, Egypt
Patient Name: Sarah Mohamed Ali
Patient ID: PAT-998877
This document serves as a formal invoice for professional radiological services rendered at our facility in Alexandria, Egypt. As a leading diagnostic center in the region, our team of certified Radiologists has provided comprehensive imaging analysis and reporting. The following charges reflect the technical fees for equipment usage, contrast media administration, and the professional interpretation fees of the attending Radiologist. All services were conducted in accordance with the medical standards and regulations enforced by the Egyptian Ministry of Health and Population.
| Description of Service | Quantity | Unit Price (EGP) | Total (EGP) |
|---|---|---|---|
|
MRI Brain with Contrast (Gadolinium) High-resolution magnetic resonance imaging of the cranial cavity. Includes intravenous contrast administration and monitoring by nursing staff. Detailed interpretation and diagnostic report provided by a Senior Radiologist specializing in Neuroradiology. |
1 | 4,500.00 | 4,500.00 |
|
CT Scan Chest (Angiography Protocol) Computed Tomography Angiography of the thoracic region to evaluate pulmonary vasculature. Includes contrast injection and post-processing 3D reconstruction. Professional review by a Chest Radiologist. |
1 | 3,200.00 | 3,200.00 |
|
Ultrasound Abdomen (Complete) Real-time sonographic evaluation of the liver, gallbladder, pancreas, spleen, kidneys, and aorta. Performed by a certified sonographer with final diagnosis confirmed by a General Radiologist. |
1 | 850.00 | 850.00 |
|
Professional Radiologist Consultation Fee Fee for the specialized medical expertise of the Radiologist in correlating clinical history with imaging findings to provide a definitive diagnosis. This fee covers the time spent analyzing complex cases and communicating with the referring physician. |
1 | 1,200.00 | 1,200.00 |
|
Digital Image Storage & Transfer (CD/USB) Provision of DICOM format images on physical media for archival purposes and second opinions. |
1 | 150.00 | 150.00 |
| Subtotal: | 9,900.00 EGP |
| VAT (14%): | 1,386.00 EGP |
| Total Amount Due: | 11,286.00 EGP |
Terms and Conditions:
1. Payment is due within 30 days of the invoice date. Late payments may incur a penalty fee as per Egyptian commercial law.
2. This invoice is issued in accordance with the Value Added Tax Law in Egypt. The Tax Registration Number is valid and active.
3. All radiological reports are the intellectual property of the Alexandria Advanced Imaging Center and the attending Radiologist. They are intended solely for the use of the patient and the referring healthcare provider.
4. In case of any discrepancies regarding the services rendered by our Radiologist or the billing amounts, please contact our finance department within 7 days of receiving this invoice.
5. We accept payments via bank transfer to our account at Banque Misr, Alexandria Branch, or cash at our reception desk.
Medical Disclaimer: The findings presented in the radiological reports are based on the images acquired at the time of the examination. The Radiologist provides a professional opinion based on current medical knowledge. This invoice does not constitute a guarantee of medical outcomes.
Authorized Signature
Dr. Khaled Ibrahim
Chief Radiologist & Medical Director
Received By
Date: _______________
Signature: _______________
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