Invoice Radiologist in Uganda Kampala –Free Word Template Download with AI
Professional Radiologist Services
Plot 45, Kololo Hill Drive
Kampala, Uganda
Tel: +256 414 123 456
Email: [email protected]
TIN: UG-987654321
Invoice Number: KAR-2023-0892
Date Issued: October 24, 2023
Due Date: November 07, 2023
Reference: Patient ID #UG-7742
Bill To:
Mukasa General Hospital
Attn: Finance Department
Plot 12, Entebbe Road
Kampala, Uganda
Contact: Dr. Sarah Nalubega
Email: [email protected]
Services Rendered
The following invoice details the professional fees for diagnostic imaging interpretation and radiological consultation services provided by our certified Radiologist team in Kampala, Uganda. All procedures were conducted in accordance with the Uganda Medical and Dental Practitioners Council standards.
| # | Description of Radiological Service | Date | Qty | Amount (UGX) |
|---|---|---|---|---|
| 1 |
CT Scan Interpretation (Head & Neck) Comprehensive analysis by Senior Radiologist including detailed report for trauma assessment. |
Oct 20, 2023 | 1 | 450,000 |
| 2 |
MRI Scan Interpretation (Lumbar Spine) Advanced magnetic resonance imaging review for disc herniation evaluation. |
Oct 21, 2023 | 1 | 650,000 |
| 3 |
Ultrasound Abdomen (Full) Real-time sonographic examination and reporting by qualified Radiologist. |
Oct 22, 2023 | 2 | 300,000 |
| 4 |
Emergency X-Ray Interpretation (Chest & Limbs) Urgent radiological assessment for fracture and pneumonia screening. |
Oct 23, 2023 | 5 | 250,000 |
| 5 |
Specialist Radiologist Consultation Fee On-site consultation at Mukasa General Hospital regarding complex oncology cases. |
Oct 24, 2023 | 1 | 500,000 |
Payment Instructions
Please remit payment within 14 days of the invoice date to avoid late fees. Payments can be made via Mobile Money (MTN/Airtel) or Bank Transfer.
- Bank: Stanbic Bank Uganda Ltd
- Branch: Kampala Road Branch
- Account Name: Kampala Advanced Radiology Centre
- Account Number: 100234567890
- Mobile Money: +256 772 123 456
Terms and Conditions
- This invoice represents the professional fees for the Radiologist services rendered in Kampala, Uganda.
- All diagnostic reports are confidential and intended solely for the referring physician and patient.
- Late payments will incur a penalty of 2% per month on the outstanding balance.
- Disputes regarding this invoice must be raised within 7 days of receipt.
- This document serves as an official receipt upon confirmation of payment.
Authorized By (Provider)
Dr. James Okello, MBChB, FRCS
Lead Radiologist
Received By (Client)
__________________________
Date: ____________________
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