Invoice Surgeon in Pakistan Islamabad –Free Word Template Download with AI
Consultant Surgeon & Head of Department
Islamabad Medical Complex
F-8 Markaz, Islamabad, Pakistan
Phone: +92-51-1234567 | Email: [email protected]
Invoice #: ISB-SRG-2023-0892
Date: October 24, 2023
Due Date: November 07, 2023
Bill To:
Mr. Bilal Siddiqui
House # 12, Street # 5
G-9/4, Islamabad, Pakistan
Phone: +92-300-9876543
NIC: 35202-1234567-1
Insurance / Payment Info:
Insurance Provider: Jubilee Health Insurance
Policy Number: JHI-PAK-998877
Group ID: GOV-EMP-2023
Payment Method: Bank Transfer / Cash
| # | Description of Surgical Services | Date of Service | Quantity | Unit Price (PKR) | Total (PKR) |
|---|---|---|---|---|---|
| 1 | Pre-operative Consultation & Assessment by Surgeon | Oct 15, 2023 | 1 | 5,000 | 5,000 |
| 2 | Laparoscopic Cholecystectomy (Surgical Procedure) | Oct 18, 2023 | 1 | 150,000 | 150,000 |
| 3 | Anesthesia Services (General Anesthesia) | Oct 18, 2023 | 1 | 25,000 | 25,000 |
| 4 | Operating Room Charges (Islamabad Medical Complex) | Oct 18, 2023 | 1 | 40,000 | 40,000 |
| 5 | Post-operative Hospital Stay (2 Nights, Private Ward) | Oct 18-20, 2023 | 2 | 15,000 | 30,000 |
| 6 | Diagnostic Tests (Blood Work, Ultrasound, ECG) | Oct 15, 2023 | 1 | 8,500 | 8,500 |
| 7 | Pharmaceuticals & Medications (Post-Surgery) | Oct 18-20, 2023 | 1 | 12,000 | 12,000 |
| 8 | Follow-up Consultation with Surgeon | Oct 24, 2023 | 1 | 3,500 | 3,500 |
| Subtotal: | PKR 274,000 |
| Discount (Insurance Coverage): | -PKR 180,000 |
| Service Tax (17% on Patient Share): | PKR 16,080 |
| Total Due: | PKR 110,080 |
Terms and Conditions:
1. This invoice is issued by Dr. Ahmed Khan, a licensed Surgeon practicing in Islamabad, Pakistan, in accordance with the regulations of the Pakistan Medical Commission (PMC).
2. Payment is due within 14 days of the invoice date. Late payments may incur a penalty of 2% per month.
3. Insurance claims should be submitted directly to Jubilee Health Insurance with a copy of this invoice and the patient's policy details.
4. All surgical procedures were performed at the Islamabad Medical Complex, F-8 Markaz, Islamabad, Pakistan, under sterile and professional conditions.
5. For any discrepancies or questions regarding this invoice, please contact our billing department at +92-51-1234567 or email [email protected].
6. This document serves as an official receipt for tax and insurance purposes in Pakistan.
Authorized Signature
Dr. Ahmed Khan, MS, FCPS
Consultant Surgeon
Patient Signature
Mr. Bilal Siddiqui
Date: _______________
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