Invoice Surgeon in Sri Lanka Colombo –Free Word Template Download with AI
Consultant Surgeon | MBBS, MRCS, FRCS (Edinburgh)
Specialist in General & Laparoscopic Surgery
Colombo Medical Center
No. 45, Galle Road, Colombo 03, Sri Lanka
Tel: +94 11 234 5678 | Email: [email protected]
Invoice No: INV-2024-0892
Date: October 15, 2024
Due Date: October 30, 2024
Billed To:
Patient Name: Mrs. Kamala Perera
Address: No. 12, Lake House Road, Colombo 07, Sri Lanka
NIC No: 198567891234
Contact: +94 77 123 4567
Insurance / Payment Details:
Insurance Provider: Ceylon Insurance PLC
Policy No: CI-MED-456789
Referral Code: REF-2024-345
Hospital: Nawaloka Hospital, Colombo
Professional Surgeon Services Rendered
The following invoice details the professional surgical services provided by Dr. Anura Jayawardena, a qualified surgeon practicing in Sri Lanka Colombo. This document serves as an official record of medical procedures, consultations, and related surgical care delivered at accredited medical facilities within Colombo. All charges reflect standard medical billing practices in Sri Lanka and are subject to applicable taxes and regulations.
| Description of Service | Date of Service | Quantity | Unit Price (LKR) | Total (LKR) |
|---|---|---|---|---|
| Pre-operative Surgical Consultation & Assessment | October 01, 2024 | 1 | 15,000.00 | 15,000.00 |
| Laparoscopic Cholecystectomy (Gallbladder Removal) | October 05, 2024 | 1 | 250,000.00 | 250,000.00 |
| Anesthesia Coordination & Surgical Team Supervision | October 05, 2024 | 1 | 45,000.00 | 45,000.00 |
| Post-operative Ward Rounds & Monitoring (3 Days) | October 06-08, 2024 | 3 | 8,000.00 | 24,000.00 |
| Wound Care & Dressing Change | October 08, 2024 | 1 | 5,000.00 | 5,000.00 |
| Follow-up Consultation & Recovery Assessment | October 12, 2024 | 1 | 10,000.00 | 10,000.00 |
| Surgical Report & Medical Documentation | October 14, 2024 | 1 | 3,000.00 | 3,000.00 |
| Subtotal: | LKR 352,000.00 |
| VAT (18%): | LKR 63,360.00 |
| Insurance Adjustment: | -LKR 150,000.00 |
| Total Amount Due: | LKR 265,360.00 |
Important Notes & Terms:
This invoice is issued by a licensed surgeon operating within Sri Lanka Colombo in accordance with the Medical Council of Sri Lanka regulations. All surgical procedures were performed at accredited hospitals in Colombo with full compliance to national healthcare standards. Payment is due within 15 days of the invoice date. Late payments may incur a 2% monthly interest charge. Insurance claims should be submitted directly to the respective provider with a copy of this invoice. For any queries regarding this invoice or the surgical services provided, please contact the surgeon's office in Colombo during business hours (9:00 AM - 5:00 PM, Monday to Saturday). This document is valid for tax purposes and insurance reimbursement in Sri Lanka.
Bank Transfer Details:
Bank: Commercial Bank of Ceylon
Account Name: Dr. Anura Jayawardena
Account No: 1234567890123
Branch: Colombo Fort
Authorized Signature
Dr. Anura Jayawardena
Consultant Surgeon
Patient / Guarantor Signature
Date: _______________
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