Purchase Order Orthodontist in Thailand Bangkok –Free Word Template Download with AI

Purchase Order No.: PO-THB-2025-0417
Date of Issue: 15 June 2025
Valid Until: 15 July 2025 Payment Terms: Net 30 Days
Currency: Thai Baht (THB)
Incoterms: DDP Bangkok

Field	Details
Company Name	OrthoSupply Asia Pacific Co., Ltd.
Address	45 Rama IX Road, Huai Khwang, Bangkok 10310, Thailand
Contact Person	Mr. Somchai Prasert, Procurement Manager
Phone	+66-2-714-3322
Email	[email protected]
Tax ID	0105557788456

Field	Details
Delivery Location	SmileCare Orthodontic Center, 128 Sukhumvit Road, Soi 21, Khlong Toei Nuea, Watthana, Bangkok 10110, Thailand
Receiving Contact	Dr. Ananya Rattanakul, Lead Orthodontist
Phone	+66-89-556-7788
Delivery Window	Monday to Friday, 09:00 – 16:00 (Bangkok local time)

LINE ITEMS – ORTHODONTIC EQUIPMENT AND SUPPLIES

#	Description	Part / SKU No.	Qty	Unit	Unit Price (THB)	Total (THB)
1	Self-Ligating Orthodontic Brackets – Ceramic, 0.022" slot (full arch set, upper and lower)	SLB-CER-022	40	Set	4,850.00	194,000.00
2	NiTi Archwires – 0.014" to 0.021" x 0.025" (12-pack per size)	NITI-AW-12PK	60	Pack	1,250.00	75,000.00
3	Elastomeric Ligatures – Assorted Colors, 1000 pcs per box	ELAST-1000-ASS	25	Box	680.00	17,000.00
4	Orthodontic Bonding Agent Kit (primer, adhesive, light-cure)	BOND-ORTHO-KIT	30	Kit	2,340.00	70,200.00
5	Interproximal Reduction (IPR) Strips – Medium Grit, 50 per pack	IPR-MED-50	50	Pack	420.00	21,000.00
6	Orthodontic Impression Trays – Stock, Assorted Sizes (20 per set)	IMP-TRAY-20	15	Set	1,890.00	28,350.00
7	Clear Aligner Retainer Material – Thermoplastic Sheets, 1.5mm (100 sheets)	ALIGN-TP-150	20	Roll	3,560.00	71,200.00
8	Orthodontic Forceps and Pliers Set (12-piece professional set)	ORTHO-PLR-12	8	Set	12,400.00	99,200.00
9	Composite Resin for Orthodontic Bonding – A2 Shade, 4g syringe	COMP-A2-4G	40	Syringe	890.00	35,600.00
10	Patient Instruction Booklets – Thai/English Bilingual (500 copies)	PAT-BOOK-TH-EN	5	Bundle	2,100.00	10,500.00

Subtotal					622,050.00 THB
VAT (7%)					43,543.50 THB
GRAND TOTAL					665,593.50 THB

NOTE: This Purchase Order is issued by SmileCare Orthodontic Center Co., Ltd., a licensed orthodontic practice registered with the Thai Ministry of Public Health. All orthodontic materials listed above must comply with Thai FDA (Food and Drug Administration) regulations and carry valid CE or ISO 13485 certification. The supplier is required to provide certificates of conformity and lot traceability documentation for each shipment delivered to our Bangkok facility. TERMS AND CONDITIONS

This Purchase Order constitutes a binding agreement between SmileCare Orthodontic Center Co., Ltd. (hereinafter "Buyer") and OrthoSupply Asia Pacific Co., Ltd. (hereinafter "Supplier") for the supply of orthodontic equipment and consumables as itemized above.
All goods must be delivered to the Buyer's orthodontic clinic located in Thailand Bangkok, specifically at 128 Sukhumvit Road, Soi 21, Khlong Toei Nuea, Watthana, Bangkok 10110. Delivery shall be completed no later than 30 June 2025.
The Supplier warrants that all orthodontic products supplied under this Purchase Order are new, unused, and manufactured in accordance with applicable Thai and international medical device standards. Any product found to be defective, expired, or non-compliant shall be replaced at the Supplier's sole expense within five (5) business days.
Payment shall be made via bank transfer to the Supplier's designated account within thirty (30) calendar days from the date of receipt of a valid Tax Invoice (Fap Ka) issued in accordance with Thai Revenue Department regulations. The Buyer reserves the right to withhold payment for any disputed line items pending resolution.
The Supplier shall bear all risks of loss or damage to the orthodontic goods until they are received and inspected at the Buyer's Bangkok premises. Title shall pass upon full payment.
Partial shipments are not permitted unless expressly authorized in writing by the Buyer's procurement department. All items under this Purchase Order must arrive in a single consolidated delivery to minimize disruption to the orthodontist's clinical schedule.
Any changes, amendments, or cancellations to this Purchase Order must be made in writing and signed by authorized representatives of both parties. Verbal modifications shall not be enforceable.
This Purchase Order shall be governed by and construed in accordance with the laws of the Kingdom of Thailand. Any disputes arising herefrom shall be subject to the exclusive jurisdiction of the competent courts in Bangkok, Thailand.
The Supplier acknowledges that the orthodontic materials procured under this order will be used in direct patient care by a licensed orthodontist and therefore must meet the highest standards of biocompatibility, sterility, and quality assurance.

AUTHORIZATION AND SIGNATURES For and on behalf of the Buyer:

______________________________
Dr. Ananya Rattanakul
Lead Orthodontist / Authorized Signatory
SmileCare Orthodontic Center Co., Ltd.
Date: _______________ For and on behalf of the Supplier:

______________________________
Mr. Somchai Prasert
Procurement Manager
OrthoSupply Asia Pacific Co., Ltd.
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX

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