Invoice Surgeon in Uzbekistan Tashkent –Free Word Template Download with AI

Bill To:

Patient Name: John Doe

Address: 45 Navoi Street, Mirzo Ulugbek District

City: Tashkent, Uzbekistan

Passport ID: AB1234567

Service Provider:

Lead Surgeon: Dr. Alisher Karimov, MD, FACS

Specialty: General & Laparoscopic Surgery

License No: UZ-MED-998877

Department: Department of Minimally Invasive Surgery

Description of Medical Services Rendered

The following invoice details the professional fees and associated costs for surgical procedures performed at our facility in Tashkent. This document serves as an official record of the surgeon's services provided to the patient under the healthcare regulations of Uzbekistan.

#	Description of Service	Quantity	Unit Price (UZS)	Total (UZS)
1	Pre-operative Surgical Consultation Comprehensive evaluation by the lead surgeon, review of medical history, physical examination, and formulation of the surgical plan. Includes discussion of risks and benefits in accordance with Tashkent medical standards.	1	1,500,000	1,500,000
2	Laparoscopic Cholecystectomy Procedure Surgical removal of the gallbladder performed by Dr. Karimov. Includes use of advanced laparoscopic equipment, surgical instruments, and sterile field maintenance within the operating theater.	1	12,000,000	12,000,000
3	Anesthesia Services General anesthesia administration and monitoring by certified anesthesiologist during the surgical procedure. Includes pre-anesthesia assessment and post-anesthesia recovery monitoring.	1	3,500,000	3,500,000
4	Operating Room Facility Fee Usage of the surgical suite, nursing staff assistance, and sterilization services provided by the Tashkent Advanced Surgical Center.	1	4,000,000	4,000,000
5	Post-operative Surgeon Follow-up Immediate post-surgical care, wound inspection, and discharge instructions provided by the operating surgeon. Includes one follow-up visit within 7 days.	1	1,000,000	1,000,000
6	Diagnostic Imaging (Ultrasound) Pre-surgical abdominal ultrasound to confirm diagnosis and surgical approach.	1	800,000	800,000

Subtotal: 22,800,000 UZS VAT (12%): 2,736,000 UZS Insurance Deduction: -5,000,000 UZS TOTAL DUE: 20,536,000 UZS

Amount in words: Twenty Million Five Hundred Thirty-Six Thousand Uzbekistan Som.

Payment Terms & Conditions

Currency: All amounts are denominated in Uzbekistan Som (UZS).
Due Date: Payment is due within 14 days of the invoice date.
Bank Transfer: Payments can be made via bank transfer to "Tashkent City Bank", Account No: 12345678901234567890, SWIFT: TASHUZ2X.
Late Fees: A late fee of 2% per month will be applied to overdue balances.
Disputes: Any discrepancies regarding the surgeon's fees or services must be reported within 7 days of receiving this invoice.

Important Medical & Legal Notice

This invoice represents the financial agreement between the patient and the Tashkent Advanced Surgical Center for the surgical services rendered. The surgeon, Dr. Alisher Karimov, has performed all duties in accordance with the medical ethics and legal standards of Uzbekistan. This document does not constitute a guarantee of medical outcome but serves as proof of service delivery. Patients are advised to keep this invoice for insurance claims and personal records.

Authorized by:

Dr. Alisher Karimov

Lead Surgeon

Received by:

Patient Signature

Date: _______________

Tashkent Advanced Surgical Center is a registered medical entity in the Republic of Uzbekistan. All surgical procedures are conducted under the supervision of licensed medical professionals. This invoice is generated in compliance with the Tax Code of Uzbekistan. For any inquiries regarding billing or surgical records, please contact our administrative office in Tashkent during business hours (09:00 - 18:00, Monday to Friday). Thank you for trusting our surgeon and our facility with your healthcare needs.

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