Invoice Veterinarian in Japan Tokyo –Free Word Template Download with AI
2-14-8 Shibuya, Shibuya-ku, Tokyo 150-0002, Japan
Phone: +81-3-5411-7820 | Fax: +81-3-5411-7821
Email: [email protected]
License No.: JP-VET-2024-08834
Billed To (Client)
Name: Mr. Kenji Tanaka
Address: 45-3-12 Roppongi, Minato-ku, Tokyo 106-0032, Japan
Phone: +81-90-5521-3347
Email: [email protected]
Client ID: TCVC-2023-00912
Patient Information
Pet Name: Hana
Species / Breed: Dog / Shiba Inu
Age: 4 years
Sex: Female (Spayed)
Microchip No.: 985-112-003-447-821
Attending Veterinarian: Dr. Yuki Matsuda, DVM
| # | Service / Description | Date of Service | Qty | Unit Price (JPY) | Amount (JPY) |
|---|---|---|---|---|---|
| 1 | Comprehensive Physical Examination & Diagnostic Consultation by Lead Veterinarian | June 10, 2025 | 1 | 12,000 | 12,000 |
| 2 | Full Blood Panel (CBC, Biochemistry, Urinalysis) – In-House Laboratory | June 10, 2025 | 1 | 18,500 | 18,500 |
| 3 | Digital Radiography (Chest & Abdomen, 2 Views) | June 10, 2025 | 1 | 15,000 | 15,000 |
| 4 | Abdominal Ultrasound Examination with Detailed Report | June 11, 2025 | 1 | 22,000 | 22,000 |
| 5 | Prescription Medication – Carprofen 75mg Tablets (30-count) for Post-Procedure Anti-Inflammatory Care | June 11, 2025 | 1 | 6,800 | 6,800 |
| 6 | Dental Cleaning & Scaling Under General Anesthesia (Full Mouth, 12 Teeth Treated) | June 11, 2025 | 1 | 45,000 | 45,000 |
| 7 | Extraction of 2 Premolars (Upper Left & Lower Right) with Suture | June 11, 2025 | 2 | 8,500 | 17,000 |
| 8 | Post-Operative Monitoring & Recovery Room (4 Hours) | June 11, 2025 | 1 | 10,000 | 10,000 |
| 9 | Follow-Up Re-Examination & Wound Check by Attending Veterinarian | June 12, 2025 | 1 | 5,000 | 5,000 |
| 10 | Annual Core Vaccinations (DHPP + Rabies) – Administered per Japan Tokyo Municipal Health Ordinance | June 12, 2025 | 1 | 9,500 | 9,500 |
| Subtotal | 161,800 JPY |
| Consumption Tax (10%) | 16,180 JPY |
| Insurance Adjustment (Pet Insurance – All Nippon Pet Care) | -48,540 JPY |
| Grand Total Due | 129,440 JPY |
Payment Instructions
Bank Transfer: Mizuho Bank, Shibuya Branch | Account Name: Tokyo Central Veterinarian Clinic | Account No.: 214-558-902 | Branch Code: 013
Credit Card: Visa, Mastercard, JCB accepted at our front desk in Shibuya, Tokyo
Convenience Payment: Pay-easy code available upon request at our Japan Tokyo clinic office
Please reference Invoice No. TCV-2025-04187 in all payment communications.
Important Notes & Terms
1. This Invoice is issued by Tokyo Central Veterinarian Clinic, a licensed veterinary practice registered under the Japan Tokyo Metropolitan Government Veterinary Medical Association. All services rendered comply with the Animal Medical Care Act of Japan.
2. The attending Veterinarian, Dr. Yuki Matsuda, has reviewed all diagnostic findings and confirmed that the procedures listed above were medically necessary for the continued health and well-being of the patient, Hana.
3. Please present this Invoice along with your pet insurance claim form to your insurer within 30 days of the date of service. Our Japan Tokyo billing office can provide supplementary documentation upon written request.
4. A follow-up appointment is recommended in 6 weeks to monitor dental healing and overall recovery. This follow-up is not included in the current Invoice and will be billed separately.
5. Payment is due within 30 days of the Issue Date. A late payment surcharge of 5% will be applied to any balance outstanding beyond the Due Date, in accordance with our standard billing policy as a Veterinarian practice in Japan Tokyo.
6. If you have any questions regarding this Invoice or the veterinary services provided, please contact our billing department at +81-3-5411-7820 (Mon–Fri, 9:00–17:00 JST) or email [email protected].
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