Invoice Surgeon in Philippines Manila –Free Word Template Download with AI
123 Medical Avenue, Makati City, Metro Manila, Philippines
Tel: +63 2 8123 4567 | Email: [email protected]
PhilHealth Accredited | HMO Partner Facility
Bill To:
Mr. Juan Dela Cruz
456 Rizal Street, Quezon City
Metro Manila, Philippines
Contact: +63 917 123 4567
Invoice Details:
Invoice Number: MSC-2023-00123
Date of Issue: October 15, 2023
Due Date: November 15, 2023
Patient ID: P-789012
This invoice pertains to the surgical procedures and related medical services provided by our team of highly qualified surgeons at Manila Surgical Center, located in the heart of Metro Manila, Philippines. Our facility is committed to delivering world-class surgical care in compliance with the standards set by the Philippine Medical Association and the Department of Health.
| Description | Quantity | Unit Price (PHP) | Total (PHP) |
|---|---|---|---|
| Consultation with Lead Surgeon | 1 | 2,500.00 | 2,500.00 |
| Pre-operative Assessment and Diagnostics | 1 | 5,000.00 | 5,000.00 |
| Laparoscopic Cholecystectomy (Gallbladder Removal) | 1 | 150,000.00 | 150,000.00 |
| Anesthesia Services | 1 | 25,000.00 | 25,000.00 |
| Operating Room Fees | 1 | 30,000.00 | 30,000.00 |
| Post-operative Care and Monitoring (3 days) | 3 | 15,000.00 | 45,000.00 |
| Pharmaceuticals and Medical Supplies | 1 | 10,000.00 | 10,000.00 |
| Follow-up Consultation with Surgeon | 2 | 1,500.00 | 3,000.00 |
Subtotal: PHP 270,500.00
PhilHealth Coverage: -PHP 50,000.00
HMO Coverage: -PHP 30,000.00
Total Amount Due: PHP 190,500.00
Payment Terms and Notes:
Payment is due within 30 days from the date of this invoice. Please make checks payable to "Manila Surgical Center" or use our bank details provided below. Late payments may incur a 1.5% monthly interest charge.
Bank Details:
Bank Name: BDO Unibank
Account Name: Manila Surgical Center Inc.
Account Number: 1234-5678-9012
Branch: Makati Main Branch
This invoice is issued in accordance with the regulations of the Bureau of Internal Revenue (BIR) of the Philippines. For any inquiries regarding this invoice or the services provided by our surgeons, please contact our billing department at the phone number or email listed above.
Manila Surgical Center is proud to serve the community of Metro Manila and the greater Philippines with excellence in surgical care. Our team of surgeons is dedicated to ensuring the best possible outcomes for every patient.
Authorized Signature:
Dr. Maria Santos, MDChief of Surgery
Manila Surgical Center ⬇️ Download as DOCX Edit online as DOCX
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