Purchase Order Doctor General Practitioner in Thailand Bangkok –Free Word Template Download with AI
128 Sukhumvit Road, Khlong Toei, Bangkok 10110, Thailand
Tax ID: 0105558923417 | VAT Reg: 0105558923417
Phone: +66 (0) 2 255 8800 | Email: [email protected]
Purchase OrderPurchase Order Details
PO Number: PO-TH-BKK-2025-04782
Date of Issue: 15 June 2025
Required Delivery Date: 30 June 2025
Payment Terms: Net 30 Days
Currency: Thai Baht (THB)
Status: APPROVED
Supplier / Service Provider
Name: Dr. Ananda Chaiyaporn, M.D.
Designation: Doctor General Practitioner
License No.: 45-2019-TH-08834
Address: 45 Phrom Phong Road, Watthana, Bangkok 10110, Thailand
Tax ID: 1103700456789
Contact: +66 (0) 89 555 2211
Delivery / Service Location
Facility: Siam Wellness Clinic, Branch 7
Address: 89 Rama IX Road, Huai Khwang, Bangkok 10310, Thailand
Department: Primary Care & General Medicine
Point of Contact: Ms. Siriporn T., Operations Manager
Phone: +66 (0) 2 711 4455
| No. | Description of Service / Item | Quantity | Unit | Unit Price (THB) | Total Amount (THB) | Delivery |
|---|---|---|---|---|---|---|
| 1 | Doctor General Practitioner – Outpatient Consultation Services (General Medicine, Preventive Health, Chronic Disease Management) at Siam Wellness Clinic, Bangkok | 120 | Consultations | 1,800.00 | 216,000.00 | Monthly |
| 2 | Doctor General Practitioner – On-Call Emergency Triage Coverage (Weekend & Public Holidays, Bangkok Metropolitan Area) | 16 | Shifts | 8,500.00 | 136,000.00 | As scheduled |
| 3 | Doctor General Practitioner – Annual Health Screening Program Administration (Corporate Clients, Bangkok CBD) | 250 | Screenings | 2,200.00 | 550,000.00 | Q3 2025 |
| 4 | Medical Examination Equipment – Digital Stethoscope, Otoscope, Ophthalmoscope, Blood Pressure Monitor (for Doctor General Practitioner use) | 1 | Set | 45,000.00 | 45,000.00 | 30 Jun 2025 |
| 5 | Diagnostic Consumables – Rapid Test Kits, ECG Paper, Urine Dipsticks, Blood Collection Tubes (6-month supply for Doctor General Practitioner clinic) | 6 | Months | 18,500.00 | 111,000.00 | Monthly |
| 6 | Electronic Medical Records (EMR) Software License – Doctor General Practitioner Module (Thai & English interface, Bangkok data center hosting) | 1 | License | 120,000.00 | 120,000.00 | 1 Jul 2025 |
| 7 | Continuing Medical Education (CME) Subsidy – Doctor General Practitioner Professional Development (Thai Medical Council accredited courses, Bangkok venues) | 4 | Workshops | 12,000.00 | 48,000.00 | Quarterly |
| 8 | Malpractice & Professional Liability Insurance – Doctor General Practitioner (Annual policy, Thailand-registered insurer) | 1 | Policy | 95,000.00 | 95,000.00 | 1 Jul 2025 |
Subtotal:1,321,000.00 THB
VAT (7% – Thailand Revenue Code):92,470.00 THB
Grand Total:1,413,470.00 THB
Terms and Conditions – Purchase Order PO-TH-BKK-2025-04782
- This Purchase Order is issued by Siam Wellness Medical Group Co., Ltd. for the engagement of a Doctor General Practitioner to provide primary healthcare services at our facility located in Thailand Bangkok. All services shall be rendered in accordance with the standards set by the Thai Medical Council and the Ministry of Public Health, Thailand.
- The Doctor General Practitioner named herein must hold a valid medical license issued by the Thai Medical Council (License No. 45-2019-TH-08834) and must maintain continuous professional registration throughout the duration of this Purchase Order.
- Payment shall be made via bank transfer to the account designated by the Doctor General Practitioner within thirty (30) calendar days of receipt of a valid tax invoice (Fap Ko) issued in compliance with Thai Revenue Department regulations. All amounts are stated in Thai Baht (THB) and are subject to 7% Value Added Tax as per Thai tax law.
- Delivery of all physical goods, including medical examination equipment and diagnostic consumables, shall be made to the Siam Wellness Clinic, Branch 7, located at 89 Rama IX Road, Huai Khwang, Bangkok 10310, Thailand. The supplier shall bear all transportation and insurance costs until goods are received and inspected at the Bangkok delivery address.
- The Doctor General Practitioner shall comply with all applicable data protection requirements under the Personal Data Protection Act (PDPA) B.E. 2562 (2019) of Thailand when handling patient records and health information within the Thailand Bangkok service area.
- Any modifications, cancellations, or amendments to this Purchase Order must be made in writing and signed by both parties. Verbal agreements regarding changes to the scope of the Doctor General Practitioner's duties are not binding.
- In the event of a dispute arising from this Purchase Order, both parties agree to first attempt resolution through mediation in Bangkok, Thailand, in accordance with the Thai Arbitration Institute procedures. If mediation fails, the matter shall be subject to the exclusive jurisdiction of the courts of Bangkok, Thailand.
- This Purchase Order is valid for a period of twelve (12) months from the date of issue, unless terminated earlier by mutual written agreement or in the event of material breach by either party.
- All services provided by the Doctor General Practitioner under this Purchase Order in Thailand Bangkok shall be conducted in a professional, ethical, and culturally sensitive manner, respecting the diverse patient population of the Bangkok metropolitan region.
Prepared By (Buyer):
Khun Nattapong S., Procurement Director
Siam Wellness Medical Group Co., Ltd.
Date: 15 June 2025
Approved By (Buyer):
Dr. Wichai R., Chief Medical Officer
Siam Wellness Medical Group Co., Ltd.
Date: 15 June 2025
Accepted By (Supplier / Doctor General Practitioner):
Dr. Ananda Chaiyaporn, M.D.
Doctor General Practitioner
Date: _______________
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