Invoice Surgeon in Tanzania Dar es Salaam –Free Word Template Download with AI

Bill To (Patient)

Juma Mwangi

House No. 12, Masaki Peninsula

Dar es Salaam, Tanzania

ID No: TZ-99887766

Insurance / Guarantor

National Health Insurance Fund (NHIF)

Policy Number: NHIF-DSM-554433

Group ID: CORP-001

Dear Mr. Mwangi,

This document serves as the official Invoice for the comprehensive surgical procedures and medical care rendered by our team of specialized Surgeon professionals at East African Surgical Specialists. As a leading medical facility located in the heart of Tanzania Dar es Salaam, we are committed to providing world-class healthcare services that meet international standards while serving the local community.

The following charges reflect the professional fees, operating theater usage, anesthesia, and post-operative care provided during your recent admission. Our Surgeon team, led by Dr. Amina Juma, performed the necessary interventions with the highest degree of skill and care. Please review the itemized list below carefully.

#	Description of Surgical Services	Date	Quantity	Amount (TZS)
1	Consultation & Pre-operative Assessment Initial evaluation by the Lead Surgeon in Dar es Salaam to determine surgical necessity and risk factors.	Oct 20, 2023	1	150,000
2	Laparoscopic Cholecystectomy Surgical removal of the gallbladder performed by a certified Surgeon. Includes use of advanced laparoscopic equipment available at our Dar es Salaam facility.	Oct 21, 2023	1	2,500,000
3	General Anesthesia Administration and monitoring by a specialized anesthesiologist during the surgical procedure.	Oct 21, 2023	1	600,000
4	Operating Theater Fees Usage of sterile surgical suite, nursing staff, and sterilization protocols compliant with Tanzania medical regulations.	Oct 21, 2023	1	800,000
5	Post-Operative Ward Stay (2 Nights) Inpatient care, monitoring, and medication management following the surgery.	Oct 21-23, 2023	2	600,000
6	Pharmaceuticals & Consumables Antibiotics, pain management, IV fluids, and surgical supplies used during the procedure.	Oct 21-23, 2023	1	350,000
7	Follow-up Consultation Post-surgery review by the Surgeon to ensure proper healing and remove sutures.	Oct 24, 2023	1	100,000

Subtotal 5,100,000 TZS VAT (18%) 918,000 TZS Insurance Coverage -3,000,000 TZS Total Due 3,018,000 TZS

Payment Instructions

Please remit payment within 30 days of the invoice date. Payments can be made via bank transfer to our account at CRDB Bank, Dar es Salaam Branch.

Bank: CRDB Bank Plc
Account Name: East African Surgical Specialists Ltd
Account Number: 001234567890
Branch: Mikocheni, Dar es Salaam

Terms and Conditions

This Invoice represents the final accounting for the surgical services provided. As a licensed medical provider in Tanzania Dar es Salaam, we adhere to all local tax laws and medical billing regulations. The fees charged for the Surgeon's time and expertise are based on the standard rates approved by the Tanzania Medical Association.

If you have any questions regarding this invoice or the procedures performed by our Surgeon, please contact our billing department immediately. We value your trust in our medical team and strive to ensure transparency in all financial matters. Late payments may incur a penalty fee of 2% per month.

Thank you for choosing East African Surgical Specialists for your healthcare needs in Dar es Salaam. We wish you a speedy and complete recovery.

Authorized By:

Dr. Amina Juma

Lead Surgeon & Medical Director

Received By:

__________________________

Date: ____________________

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