Quotation Estimate Doctor General Practitioner in India Bangalore –Free Word Template Download with AI
Professional Medical Services — Doctor General Practitioner Consultation & Care Package
Serving the Community of India Bangalore
Ref: QTE/BLR/2025/04782 Issued By:Dr. Ananya Krishnamurthy, MBBS, MD (General Medicine)
Senior Doctor General Practitioner
Wellness First Primary Care Clinic
No. 42, 100 Feet Road, Indiranagar
Bangalore, Karnataka – 560038, India
Phone: +91-80-4123-5678
Email: [email protected] Quotation Estimate Details:
Date of Issue: 15 June 2025
Valid Until: 15 July 2025
Currency: Indian Rupees (INR / ’)
GSTIN: 29ABCDE1234F1Z5
Registration No.: KMC/2019/45821 1. Client / Patient Information
| Field | Details |
|---|---|
| Patient Name | Mr. Rajesh Kumar Nair |
| Address | Flat 7B, Green Meadows, HSR Layout, Sector 2, Bangalore, Karnataka – 560102, India |
| Age / Gender | 48 Years / Male |
| Referring Source | Self-Referral via India Bangalore Health Portal |
| Insurance Provider | Star Health & Allied Insurance (Policy No. SH-88234567) |
This Quotation Estimate outlines the comprehensive medical services to be rendered by our Doctor General Practitioner, Dr. Ananya Krishnamurthy, at the Wellness First Primary Care Clinic located in the heart of India Bangalore. The Doctor General Practitioner will manage all aspects of primary healthcare, including preventive screenings, chronic disease monitoring, acute illness treatment, and ongoing wellness guidance tailored to the patient’s specific health profile. All consultations and procedures described below are conducted in accordance with the Medical Council of India (MCI) guidelines and the Karnataka State Health Regulations applicable to India Bangalore.
3. Itemized Quotation Estimate Breakdown| S.No | Service Description | Frequency | Unit Cost (INR) | Total (INR) |
|---|---|---|---|---|
| 1 | Initial Comprehensive Consultation with Doctor General Practitioner (includes history, physical examination, and preliminary diagnosis) | One-time | ’1,500 | ’1,500 |
| 2 | Full Body Health Screening Panel (CBC, LFT, RFT, Lipid Profile, HbA1c, Thyroid Panel, Urine Analysis, Chest X-Ray) | One-time | ’4,200 | ’4,200 |
| 3 | Follow-up Consultation with Doctor General Practitioner (review of test results, treatment planning, medication prescription) | 2 sessions | ’1,200 | ’2,400 |
| 4 | Chronic Disease Management Program (Hypertension & Type-2 Diabetes monitoring, quarterly reviews by Doctor General Practitioner) | 4 quarters | ’2,000 | ’8,000 |
| 5 | Preventive Health Check-up (annual physical by Doctor General Practitioner, ECG, BMI assessment, lifestyle counselling) | Annual | ’2,500 | ’2,500 |
| 6 | Home Visit by Doctor General Practitioner (for patients unable to travel to India Bangalore clinic; includes travel within 10 km radius) | 2 visits | ’2,000 | ’4,000 |
| 7 | Telemedicine / Video Consultation with Doctor General Practitioner (for minor follow-ups, prescription renewals, and health queries) | 4 sessions | ’800 | ’3,200 |
| 8 | Immunization & Vaccination Administration (as recommended by Doctor General Practitioner; includes tetanus booster and seasonal flu vaccine) | One-time | ’1,800 | ’1,800 |
| 9 | Health Records Management & Digital Health File (maintenance of patient records accessible via India Bangalore e-Health platform) | Annual | ’500 | ’500 |
| 10 | Emergency / Urgent Care Access (priority scheduling with Doctor General Practitioner within 24 hours for acute conditions) | Annual | ’1,000 | ’1,000 |
| Subtotal (INR) | ’29,100 | |||
| GST @ 5% (as applicable in India Bangalore healthcare services) | ’1,455 | |||
| Grand Total (INR) | ’30,555 | |||
- This Quotation Estimate is a non-binding document and does not constitute a final invoice. A formal invoice will be generated upon the patient’s written acceptance of the Doctor General Practitioner care plan.
- All services will be delivered by the designated Doctor General Practitioner or, in the event of unavailability, by an equally qualified substitute Doctor General Practitioner from the same India Bangalore clinic, with prior patient consent.
- The Doctor General Practitioner reserves the right to refer the patient to a specialist (cardiologist, endocrinologist, orthopaedic surgeon, etc.) if the clinical condition warrants advanced care beyond primary practice scope.
- Payment for this Quotation Estimate may be made via bank transfer, UPI, credit/debit card, or cash at the India Bangalore clinic reception. A 10% advance is required to confirm the care plan; the balance is due within 15 days of service delivery.
- Cancellation or rescheduling of Doctor General Practitioner appointments must be communicated at least 24 hours in advance. Late cancellations may incur a 25% fee of the scheduled consultation charge.
- All medical records generated under this Quotation Estimate are the property of the patient and may be requested in digital or printed format at any time, in compliance with India’s Digital Personal Data Protection Act, 2023.
- This Quotation Estimate is governed by the laws of India and the jurisdiction of the competent courts in Bangalore, Karnataka.
- The Doctor General Practitioner and the clinic shall not be held liable for adverse outcomes arising from the patient’s non-compliance with prescribed treatment, medication schedules, or lifestyle recommendations.
By signing below, the patient (or authorized guardian) acknowledges receipt of this Quotation Estimate and agrees to the terms outlined above for the Doctor General Practitioner services to be provided in India Bangalore.
For & On Behalf of:
Wellness First Primary Care Clinic
India Bangalore
Doctor General Practitioner
Signature & Date
Patient / Authorized Guardian:
Mr. Rajesh Kumar Nair
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