Quotation Estimate Dentist in Myanmar Yangon –Free Word Template Download with AI
125, 27th Street, Kamayut Township, Yangon, Myanmar
Phone: +95-9-795-123-456 | Email: [email protected]
License No. MY-DENT-2019-04521 | Registered with Myanmar Dental Association
Quotation EstimateQuotation Details
Quotation No.: GSD-QE-2025-0387
Date of Issue: 15 June 2025
Valid Until: 15 July 2025 (30 days)
Currency: Myanmar Kyat (MMK)
Client Information
Name: U Kyaw Min Aung
Address: 45, 34th Street, Insein Township, Yangon, Myanmar
Phone: +95-9-456-789-012
Referral By: Dr. Thiri Win (General Practitioner)
Dear U Kyaw Min Aung,
Thank you for visiting Golden Smile Dental Clinic in Yangon, Myanmar, and for entrusting us with your dental care needs. Following your comprehensive consultation and diagnostic examination conducted on 12 June 2025, our lead Dentist, Dr. Aung Myo Htun (BDS, MDS – Restorative Dentistry), has prepared this detailed Quotation Estimate outlining the recommended treatment plan, associated costs, and projected timeline for your complete dental rehabilitation.
This Quotation Estimate reflects the current standard rates for all dental procedures performed at our clinic in Yangon, Myanmar. All prices are inclusive of diagnostic imaging, local anesthesia, and post-operative follow-up consultations within the specified treatment period. Please review each line item carefully before providing your written acceptance.
Itemized Treatment Plan & Cost Breakdown| No. | Dental Procedure / Service | Description | Qty | Unit Price (MMK) | Total (MMK) |
|---|---|---|---|---|---|
| 1 | Full Oral Examination & Digital X-Ray (Panoramic + Periapical) | Comprehensive diagnostic imaging and clinical assessment by the Dentist | 1 | 45,000 | 45,000 |
| 2 | Professional Scaling & Polishing (Ultrasonic) | Removal of calculus, tartar, and plaque buildup; enamel polishing | 1 | 85,000 | 85,000 |
| 3 | Composite Resin Filling (Posterior Teeth – 3 units) | 3M Z350XT composite material; shade-matched restoration | 3 | 120,000 | 360,000 |
| 4 | Root Canal Treatment (Single-Root Molar – 1 unit) | Endodontic therapy with gutta-percha obturation; includes 2 visits | 1 | 450,000 | 450,000 |
| 5 | Full-Ceramic Crown (E.max Zirconia – 1 unit) | Lab-fabricated zirconia crown; try-in and cementation included | 1 | 1,200,000 | 1,200,000 |
| 6 | Extraction of Impacted Wisdom Tooth (Lower Left – 3rd Molar) | Surgical extraction under local anesthesia; suturing and post-op care | 1 | 350,000 | 350,000 |
| 7 | Periodontal Deep Cleaning (Scaling & Root Planing – 4 quadrants) | Treatment of moderate periodontitis; subgingival debridement | 4 | 95,000 | 380,000 |
| 8 | Fluoride Varnish Application (Full Arch) | Protective fluoride treatment for enamel strengthening | 1 | 35,000 | 35,000 |
| 9 | Post-Operative Follow-Up Consultations (3 visits) | Healing checks, suture removal, and final evaluation by the Dentist | 3 | 25,000 | 75,000 |
| 10 | Prescription Medications & Aftercare Kit | Antibiotics, analgesics, antiseptic mouthwash, soft-bristle toothbrush | 1 | 55,000 | 55,000 |
| GRAND TOTAL (All Inclusive) | MMK 3,090,000 | ||||
1. Validity: This Quotation Estimate is valid for thirty (30) calendar days from the date of issue. After the expiry date, prices may be revised to reflect current material costs and the Dentist's updated fee schedule in Yangon, Myanmar.
2. Payment Schedule: A 50% deposit (MMK 1,545,000) is required at the time of acceptance to reserve your treatment slots. The remaining 50% balance (MMK 1,545,000) is due upon completion of the final procedure. Payment may be made via cash, bank transfer (CB Bank, AYA Bank, or KBZ Bank), or mobile payment (Wave Money, KBZPay).
3. Treatment Timeline: The complete treatment plan is projected to be completed within four (4) to six (6) weeks, subject to the Dentist's clinical judgment and your availability for scheduled appointments at our Yangon clinic.
4. Cancellation & Rescheduling: Appointments may be rescheduled up to 48 hours in advance without penalty. Cancellations made less than 48 hours prior to a scheduled visit will incur a 20% fee of the procedure cost for that session.
5. Warranty: All restorative work (crowns, fillings, root canal treatments) carries a twelve-month warranty from the date of cementation or completion. The warranty covers material defects and procedural failures but does not cover damage resulting from trauma, neglect, or failure to attend scheduled follow-up visits.
6. Confidentiality: All patient records, radiographs, and clinical notes are maintained in strict accordance with Myanmar's data protection regulations and the ethical standards of the Myanmar Dental Association. No information will be disclosed without your written consent.
7. Governing Jurisdiction: This Quotation Estimate and any resulting service agreement shall be governed by the laws of the Republic of the Union of Myanmar. Any disputes shall be resolved through mediation in Yangon, Myanmar.
Acceptance & AuthorizationBy signing below, the client acknowledges that they have read, understood, and accepted all terms outlined in this Quotation Estimate. The client authorizes the Dentist and the clinical team at Golden Smile Dental Clinic, Yangon, Myanmar, to proceed with the recommended treatment plan as described herein.
Client SignatureName: U Kyaw Min Aung
Date: _______________
Dentist / Authorized RepresentativeDr. Aung Myo Htun, BDS, MDS
Golden Smile Dental Clinic, Yangon
Date: _______________
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