Invoice Surgeon in Myanmar Yangon –Free Word Template Download with AI
123 Bogyoke Aung San Road, Kamayut Township
Yangon, Myanmar
Tel: +95 1 234 5678 | Email: [email protected]
Tax Registration No: MM-TAX-2023-98765
Invoice No: YISC-INV-2024-00458
Date: October 15, 2024
Due Date: November 15, 2024
BILL TO:
Patient Name: U Kyaw Min
Address: 45/7 Inya Road, Lanmadaw Township, Yangon, Myanmar
Phone: +95 9 123 456 789
National ID: 14/YGN(N)/123456
Insurance Provider: Myanmar Health Assurance Co., Ltd.
Policy Number: MHA-2024-789012
| Surgeon: | Dr. Aye Chan, MBBS, MS (Surgery), FRCS (Edinburgh) |
| Specialty: | General & Laparoscopic Surgery |
| Procedure Date: | October 10, 2024 |
| Procedure Type: | Laparoscopic Cholecystectomy (Gallbladder Removal) |
| Hospital: | Yangon International Surgical Center, Yangon, Myanmar |
| Anesthesiologist: | Dr. Thida Win, MD (Anesthesiology) |
| # | Description of Services | Qty | Unit Price (MMK) | Total (MMK) |
|---|---|---|---|---|
| 1 |
Surgeon's Professional Fee - Laparoscopic Cholecystectomy Includes pre-operative consultation, surgical procedure, and immediate post-operative care by the attending surgeon in Yangon. |
1 | 1,500,000 | 1,500,000 |
| 2 |
Anesthesia Services General anesthesia administration and monitoring during the surgical procedure. |
1 | 450,000 | 450,000 |
| 3 |
Operating Room Facility Fee Use of surgical suite, nursing staff, and standard surgical instruments at Yangon International Surgical Center. |
1 | 800,000 | 800,000 |
| 4 |
Laparoscopic Surgical Instruments & Disposables Specialized laparoscopic tools, trocars, clips, and sterile disposable items used during the procedure. |
1 | 350,000 | 350,000 |
| 5 |
Pre-operative Diagnostic Tests Includes complete blood count, liver function tests, coagulation profile, and abdominal ultrasound. |
1 | 180,000 | 180,000 |
| 6 |
Post-operative Hospital Stay (2 Nights) Semi-private room accommodation, nursing care, and routine monitoring in Yangon. |
2 | 250,000 | 500,000 |
| 7 |
Pharmaceuticals & Medications Antibiotics, analgesics, anti-emetics, and other medications administered during hospitalization. |
1 | 120,000 | 120,000 |
| 8 |
Pathology Examination Fee Histopathological analysis of the removed gallbladder tissue. |
1 | 95,000 | 95,000 |
| 9 |
Surgeon's Follow-up Consultation Post-operative wound check and recovery assessment at the Yangon clinic. |
1 | 75,000 | 75,000 |
| Subtotal: | 4,070,000 MMK |
| Insurance Coverage (70%): | -2,849,000 MMK |
| Patient Responsibility (30%): | 1,221,000 MMK |
| Early Payment Discount (2%): | -24,420 MMK |
| TOTAL DUE: | 1,196,580 MMK |
Important Notes & Payment Instructions:
This invoice represents the professional and facility fees for surgical services rendered by the surgeon at Yangon International Surgical Center, located in Yangon, Myanmar. All amounts are quoted in Myanmar Kyat (MMK). Payment is due within 30 days of the invoice date. Late payments may incur a 1.5% monthly interest charge.
Payment Methods:
- Bank Transfer: KBZ Bank, Account No: 0123-4567-8901-2345, Branch: Yangon Central
- Cash: Accepted at the hospital billing office in Yangon
- Credit Card: Visa/Mastercard accepted with 2% processing fee
Please reference Invoice No. YISC-INV-2024-00458 with all payments. For insurance claims, please submit this invoice along with the medical report and procedure documentation to your insurance provider. The surgeon and medical team at Yangon International Surgical Center are committed to providing high-quality surgical care in accordance with international medical standards.
If you have any questions regarding this invoice or the surgical services provided, please contact our billing department at +95 1 234 5678 or email [email protected]. Our office is located in Yangon, Myanmar, and is open Monday to Saturday from 8:00 AM to 5:00 PM.
Authorized by:
Dr. Aye Chan
Lead Surgeon
Yangon International Surgical Center
Received by:
U Kyaw Min
Patient
Date: _______________
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