Invoice Surgeon in Morocco Casablanca –Free Word Template Download with AI
Clinique Internationale de Casablanca
123 Boulevard Zerktouni, Anfa
Casablanca 20250, Morocco
Phone: +212 522 123 456
Email: [email protected]
Invoice Number: INV-2023-10-089
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Service Provider (Surgeon)
Dr. Ahmed Benali
Medical License No: 12345/CAS
Tax Identification Number (NIF): 001.2345.6789.000
Registered in the Order of Physicians of Morocco
Operating at Clinique Internationale de Casablanca
Billed To (Patient / Insurance)
Mohammed Alami
Patient ID: P-998877
Address: 45 Rue Ibn Battouta, Maarif
Casablanca, Morocco
Insurance Provider: Wafa Assurance
Policy Number: WA-2023-554433
Statement of Surgical Services Rendered
This invoice details the professional fees and associated costs for the surgical procedure performed by Dr. Ahmed Benali, a board-certified Surgeon, at the Clinique Internationale de Casablanca. The services were rendered in accordance with the medical standards of Morocco and the specific requirements of the patient's condition. The procedure took place on October 20, 2023.
| # | Description of Service | Date | Unit Price (MAD) | Total (MAD) |
|---|---|---|---|---|
| 1 |
Pre-Operative Consultation & Assessment Comprehensive evaluation by the Surgeon, including review of medical history, physical examination, and surgical planning for laparoscopic cholecystectomy. |
Oct 15, 2023 | 800.00 | 800.00 |
| 2 |
Laparoscopic Cholecystectomy (Surgical Procedure) Performance of minimally invasive gallbladder removal surgery by Dr. Benali. Includes surgical time, technical expertise, and intra-operative decision-making. |
Oct 20, 2023 | 12,000.00 | 12,000.00 |
| 3 |
Anesthesia Coordination & Monitoring Coordination with the anesthesiologist for general anesthesia administration and monitoring during the surgical procedure in Casablanca. |
Oct 20, 2023 | 2,500.00 | 2,500.00 |
| 4 |
Operating Room & Facility Fees Usage of the sterile operating theater, surgical instruments, and nursing staff at Clinique Internationale de Casablanca for the duration of the surgery. |
Oct 20, 2023 | 4,500.00 | 4,500.00 |
| 5 |
Post-Operative Care & Recovery Immediate post-surgical monitoring, pain management, and initial recovery care provided by the surgical team on the day of the procedure. |
Oct 20, 2023 | 1,500.00 | 1,500.00 |
| 6 |
Pathology & Laboratory Analysis Histological examination of the removed gallbladder tissue to confirm diagnosis and rule out malignancy, conducted at an accredited lab in Morocco. |
Oct 21, 2023 | 1,200.00 | 1,200.00 |
| 7 |
Follow-Up Consultation Post-operative check-up by the Surgeon to assess wound healing, review pathology results, and provide discharge instructions. |
Oct 27, 2023 | 600.00 | 600.00 |
Important Notes & Payment Terms:
- This Invoice is issued in accordance with the tax regulations of the Kingdom of Morocco.
- The Surgeon, Dr. Ahmed Benali, guarantees the professional quality of the surgical services rendered.
- Payment is due within 30 days of the invoice date. Please reference Invoice Number INV-2023-10-089 on all payments.
- Bank Transfer Details: Bank Al-Maghrib, Account No: 0001234567890123456789, IBAN: MA66 0001 2345 6789 0123 4567 89.
- Any disputes regarding this invoice must be raised in writing within 15 days of receipt.
- This document serves as an official record for insurance reimbursement purposes in Casablanca and throughout Morocco.
Authorized Signature (Surgeon)
Dr. Ahmed Benali
Patient Acknowledgment
Mohammed Alami
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