Purchase Order Orthodontist in Vietnam Ho Chi Minh City –Free Word Template Download with AI
PO Number: PO-VNM-HCM-2025-04782
Date of Issue: 15 June 2025
Valid Until: 15 July 2025
Location: Vietnam Ho Chi Minh City
Supplier / Vendor
DentalPro Asia Co., Ltd.
128 Nguyen Van Linh Street, District 1
Vietnam Ho Chi Minh City, 700000
Tax Code: 0312345678
Contact: Mr. Tran Van Minh
Email: [email protected]
Phone: +84 28 3822 4567
Buyer / Recipient
Dr. Le Thi Hoa – Orthodontist
SmileCare Orthodontic Clinic
45 Le Duan Boulevard, District 3
Vietnam Ho Chi Minh City, 700011
Tax Code: 0319876543
Contact: Dr. Le Thi Hoa
Email: [email protected]
Phone: +84 28 3930 1234
Delivery Details
Ship To: SmileCare Orthodontic Clinic
45 Le Duan Boulevard, District 3
Vietnam Ho Chi Minh City, 700011
Delivery Date: 29 June 2025
Incoterms: DDP (Delivered Duty Paid)
Payment Terms
Method: Bank Transfer (T/T)
Bank: Vietcombank – HCMC Branch
Account No: 0091001234567
Due Date: Net 30 days from invoice
Currency: VND (Vietnamese Dong)
| No. | Description | SKU / Ref. | Qty | Unit Price (VND) | Total (VND) | Remarks |
|---|---|---|---|---|---|---|
| 1 | Self-Ligating Orthodontic Brackets (Ceramic, 28 pcs/set) – for use by the Orthodontist at SmileCare Clinic | ORT-CLM-28 | 50 | 2,850,000 | 142,500,000 | For adult & adolescent patients |
| 2 | Nickel-Titanium (NiTi) Archwires, 0.014" to 0.022" – complete set per patient | ORT-NITI-SET | 100 | 1,200,000 | 120,000,000 | Heat-activated, 10 gauges |
| 3 | Orthodontic Elastomeric Ligatures (Assorted Colors, 500 pcs/bag) | ORT-ELAS-500 | 40 | 350,000 | 14,000,000 | Standard & power chain |
| 4 | Intraoral Digital Scanner (3Shape TRIOS 5) – for the Orthodontist's digital workflow | ORT-SCAN-3S5 | 1 | 285,000,000 | 285,000,000 | Includes 1-year warranty & training |
| 5 | Orthodontic Bonding Kit (Adhesive, Primer, Light-Curing Unit) | ORT-BOND-KIT | 20 | 1,850,000 | 37,000,000 | For bracket placement procedures |
| 6 | Clear Aligner Trays (Thermoform, 20 trays per case) – for the Orthodontist's aligner treatment plan | ORT-ALN-20 | 30 | 4,500,000 | 135,000,000 | Medical-grade PETG material |
| 7 | Orthodontic Headgear & Facebow Components (Complete Set) | ORT-HG-FB | 15 | 2,200,000 | 33,000,000 | Adjustable, stainless steel |
| 8 | Patient Instruction Booklets & Aftercare Kits (Vietnamese & English) | ORT-PTC-KIT | 200 | 85,000 | 17,000,000 | For new Orthodontist patients |
| Subtotal | 783,500,000 VND |
| VAT (10%) | 78,350,000 VND |
| Shipping & Handling (within Vietnam Ho Chi Minh City) | 5,000,000 VND |
| Grand Total | 866,850,000 VND |
Terms & Conditions – Purchase Order PO-VNM-HCM-2025-04782
- This Purchase Order is issued by Dr. Le Thi Hoa, a licensed Orthodontist operating SmileCare Orthodontic Clinic in Vietnam Ho Chi Minh City, and is binding upon acceptance by the supplier.
- All orthodontic products listed in this Purchase Order must comply with the Ministry of Health of Vietnam (MOH) regulations and carry valid CE or FDA certification where applicable.
- The supplier, DentalPro Asia Co., Ltd., located in Vietnam Ho Chi Minh City, shall deliver all items to the specified address no later than 29 June 2025. Late delivery beyond 5 business days entitles the Orthodontist to a 2% penalty per day on the affected line items.
- Payment shall be made within 30 days of receipt of a valid tax invoice (Hóa đơn giá trị gia tăng) issued in accordance with Vietnamese tax law. The Orthodontist reserves the right to withhold payment for any items found defective or non-conforming upon inspection.
- All medical-grade materials, including brackets, archwires, and aligner trays, must be supplied in unopened, sterile packaging with a minimum shelf life of 18 months from the date of delivery to the clinic in Vietnam Ho Chi Minh City.
- The intraoral digital scanner (Item 4) shall include on-site installation, operator training for the Orthodontist and two clinical assistants, and a comprehensive 12-month warranty covering parts and labor.
- This Purchase Order is governed by the laws of the Socialist Republic of Vietnam. Any disputes arising from this Purchase Order shall be resolved through the Commercial Arbitration Center of Vietnam Ho Chi Minh City (VIAC).
- The Orthodontist reserves the right to modify, cancel, or amend this Purchase Order in writing prior to the delivery date. Any such modification must be confirmed in writing by both parties.
- All intellectual property, patient data, and clinical records associated with the use of these orthodontic products remain the exclusive property of the Orthodontist and SmileCare Orthodontic Clinic.
- This Purchase Order constitutes the entire agreement between the parties regarding the purchase of the described orthodontic goods and supersedes all prior negotiations, representations, or agreements.
Prepared & Authorized By (Buyer)
Dr. Le Thi Hoa – OrthodontistSmileCare Orthodontic Clinic
Vietnam Ho Chi Minh City
Date: _______________
Accepted By (Supplier)
Mr. Tran Van Minh – Sales DirectorDentalPro Asia Co., Ltd.
Vietnam Ho Chi Minh City
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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