Invoice Surgeon in Pakistan Karachi –Free Word Template Download with AI
Consultant General & Laparoscopic Surgeon
Shifa International Surgical Center
Plot 45-B, Block 7, Clifton, Karachi, Sindh, Pakistan
Phone: +92-21-3587-XXXX | Email: [email protected]
Invoice #: INV-KHI-2023-0892
Date: October 24, 2023
Due Date: November 07, 2023
Bill To:
Patient Name: Mr. Bilal Hassan
Address: House 12, Street 5, DHA Phase 6, Karachi, Pakistan
Contact: +92-300-1234567
Insurance: Al-Falah Health Insurance (Policy #AF-998877)
| Description of Services | Quantity | Unit Price (PKR) | Total (PKR) |
|---|---|---|---|
| Pre-operative Surgical Consultation & Assessment | 1 | 5,000.00 | 5,000.00 |
| Surgeon's Fee for Laparoscopic Cholecystectomy | 1 | 120,000.00 | 120,000.00 |
| Operative Time (Additional 30 mins beyond standard) | 1 | 15,000.00 | 15,000.00 |
| Post-operative Ward Rounds (First 48 Hours) | 3 | 2,500.00 | 7,500.00 |
| Surgical Discharge Summary & Documentation | 1 | 2,000.00 | 2,000.00 |
| Follow-up Consultation (1 Week Post-Op) | 1 | 3,500.00 | 3,500.00 |
| Emergency On-Call Surgeon Availability Fee | 1 | 5,000.00 | 5,000.00 |
Important Notes & Payment Terms:
1. This invoice represents the professional fees charged by the Surgeon for the medical services rendered in Karachi, Pakistan. It does not include hospital charges, anesthesia fees, or pharmacy costs, which are billed separately.
2. Payment is due within 14 days of the invoice date. Late payments may incur a penalty of 2% per month.
3. For insurance claims, please submit this invoice along with the detailed operative report and discharge summary to your provider.
4. If you have any questions regarding this invoice or the surgical procedure, please contact our billing department at +92-21-3587-XXXX or visit our clinic in Clifton, Karachi.
5. All amounts are in Pakistani Rupees (PKR). Foreign currency payments are accepted at the prevailing exchange rate of the State Bank of Pakistan on the date of transaction.
Authorized by:
Dr. Ahmed Raza KhanConsultant Surgeon
Shifa International Surgical Center
Patient/Guarantor Acknowledgment:
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