Invoice Surgeon in Russia Saint Petersburg –Free Word Template Download with AI
Department of Advanced Surgical Procedures
191025, Russia, Saint Petersburg
Fontanka Embankment, 158, Building A
Tel: +7 (812) 555-01-99
Email: [email protected]
INN: 7801234567 | KPP: 780101001
Invoice Number: INV-RU-SPB-2023-8942
Date of Issue: October 24, 2023
Due Date: November 24, 2023
Currency: Russian Ruble (RUB)
Bill To:Patient Name: Mr. Alexander Petrov
Policy Number: INS-4492-SPB
Address: 197110, Russia, Saint Petersburg, Nevsky Prospekt, 45, Apt 12
Contact: +7 (921) 555-12-34
Description of Surgical Services RenderedThe following invoice details the professional fees and associated costs for surgical procedures performed at our facility in Saint Petersburg, Russia. These services were provided by our board-certified surgeons in accordance with the highest standards of medical practice required within the Russian Federation.
| Item | Description of Service | Date | Quantity | Unit Price (RUB) | Total (RUB) |
|---|---|---|---|---|---|
| 1 |
Pre-Operative Consultation & Assessment Comprehensive evaluation by Lead Surgeon Dr. Ivan Volkov. Includes review of medical history, physical examination, and surgical planning specific to the patient's condition. |
Oct 10, 2023 | 1 | 15,000.00 | 15,000.00 |
| 2 |
Diagnostic Imaging & Lab Work MRI of the lumbar spine and complete blood panel required for surgical clearance. Conducted at Neva Medical Center laboratories in Saint Petersburg. |
Oct 11, 2023 | 1 | 22,500.00 | 22,500.00 |
| 3 |
Primary Surgical Procedure: Microdiscectomy Performed by Senior Surgeon Dr. Ivan Volkov. Includes surgeon's professional fee, anesthesia services, and use of the operating theater. Procedure performed under general anesthesia. |
Oct 15, 2023 | 1 | 185,000.00 | 185,000.00 |
| 4 |
Implants and Surgical Materials Cost of biocompatible implants, sutures, and specialized surgical instruments utilized during the operation. |
Oct 15, 2023 | 1 | 45,000.00 | 45,000.00 |
| 5 |
Inpatient Hospital Stay (3 Nights) Accommodation in a private recovery room, nursing care, and post-operative monitoring immediately following the surgery. |
Oct 15-18, 2023 | 3 | 12,000.00 | 36,000.00 |
| 6 |
Post-Operative Follow-Up Wound check and initial recovery assessment by the attending surgeon. |
Oct 20, 2023 | 1 | 8,000.00 | 8,000.00 |
Please remit payment within 30 days of the invoice date. Payments can be made via bank transfer to the following account details located in Saint Petersburg:
- Bank Name: Sberbank of Russia, Saint Petersburg Branch
- Account Name: Neva Medical Center LLC
- Account Number: 40702810938000012345
- BIC: 044525225
- Correspondent Account: 30101810400000000225
- This invoice represents the final calculation for the surgical services rendered by the surgeon and medical staff at Neva Medical Center.
- All prices are inclusive of applicable taxes unless stated otherwise. VAT is calculated according to the current tax laws of the Russian Federation.
- Interest may be charged on overdue amounts at a rate of 0.05% per day.
- Please quote the Invoice Number (INV-RU-SPB-2023-8942) when making payment.
- For any discrepancies or questions regarding this invoice, please contact our billing department in Saint Petersburg immediately.
- This document serves as an official receipt for medical expenses for insurance and tax purposes.
Authorized By:
Dr. Ivan Volkov
Chief Surgeon
Neva Medical Center
Received By:
__________________________
Date: ____________________
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