Quotation Estimate Optometrist in Bangladesh Dhaka –Free Word Template Download with AI
ClearSight Optometry & Vision Care Centre
House 42, Road 11, Banani, Dhaka-1213, Bangladesh
Phone: +880-2-8812-3456 | Email: [email protected]
Registration No: BOA/2019/004521 | VAT Reg: 001234567-101
Dear Mr. Sheikh,
Thank you for considering ClearSight Optometry & Vision Care Centre for your comprehensive eye examination and vision correction needs. This Quotation Estimate has been prepared by our senior Optometrist, Dr. Nusrat Jahan (BOA Licensed, License No. BOA/2015/0089), based on your initial consultation on 10 June 2025 at our clinic in Bangladesh Dhaka. The following itemized breakdown outlines all recommended services, diagnostic procedures, and corrective products to address your diagnosed myopia (left eye: -3.25 D, right eye: -2.75 D) with mild astigmatism.
Itemized Services & Products| # | Description | Category | Qty | Unit Price (BDT) | Amount (BDT) |
|---|---|---|---|---|---|
| 1 | Comprehensive Optometrist Eye Examination (visual acuity, refraction, intraocular pressure, fundus examination, and binocular vision assessment) | Diagnostic | 1 | 2,500.00 | 2,500.00 |
| 2 | Autorefraction & Subjective Refinement by Certified Optometrist | Diagnostic | 1 | 1,200.00 | 1,200.00 |
| 3 | Corneal Topography (Pentacam) for precise astigmatism mapping | Diagnostic | 1 | 3,500.00 | 3,500.00 |
| 4 | Optical Frame – Ray-Ban RB3522 (Tortoise Acetate, 54mm) | Product | 1 | 12,500.00 | 12,500.00 |
| 5 | Single Vision Lenses – Zeiss SmartLife 1.60 Index (Blue Light Filter, Anti-Reflective Coating) | Product | 2 | 8,800.00 | 17,600.00 |
| 6 | Lens Fitting, Pupillary Distance Measurement & Frame Adjustment by Optometrist | Service | 1 | 1,000.00 | 1,000.00 |
| 7 | Follow-up Vision Check (2 weeks post-fitting) – Optometrist Consultation | Service | 1 | 800.00 | 800.00 |
| 8 | UV400 Protection Sunglasses – Polarized (Prescription-Ready) | Product | 1 | 6,500.00 | 6,500.00 |
| 9 | Annual Eye Health Screening Package (next 12 months, includes 2 visits) | Service | 1 | 4,000.00 | 4,000.00 |
| 10 | Digital Prescription Record & Printed Optometrist Certificate | Administrative | 1 | 300.00 | 300.00 |
| Subtotal (All Services & Products) | 49,900.00 BDT |
| VAT @ 15% (Applicable on Products) | 7,395.00 BDT |
| Discount – New Patient First Visit (5%) | -2,495.00 BDT |
| Grand Total (Quotation Estimate) | 54,800.00 BDT |
| In Words: Fifty-Four Thousand Eight Hundred Taka Only |
- This Quotation Estimate is valid for thirty (30) days from the date of issue. Prices are subject to change after the validity period due to currency fluctuations and supplier pricing adjustments in the Bangladesh Dhaka market.
- All diagnostic and clinical services will be performed by a licensed Optometrist registered with the Bangladesh Optometric Association (BOA). The attending Optometrist for this engagement is Dr. Nusrat Jahan.
- Payment terms: 50% advance payment upon acceptance of this Quotation Estimate; remaining 50% due upon delivery and fitting of optical products. Payment may be made via BKash, Nagad, bank transfer (IBBL, Sonali Bank), or cash at our Bangladesh Dhaka clinic.
- Optical products (frames and lenses) carry a manufacturer's warranty of 12 months against defects in material and workmanship. This does not cover damage from misuse, accidental breakage, or unauthorized repair.
- The annual eye health screening package includes two (2) follow-up visits by our Optometrist within twelve months. Additional visits will be charged at the standard consultation rate of BDT 1,500 per session.
- All prices are quoted in Bangladeshi Taka (BDT) and are inclusive of all applicable taxes unless otherwise stated. This Quotation Estimate does not include any government levies that may be imposed after the date of issue.
- Our clinic operates Monday through Saturday, 9:00 AM to 8:00 PM, and Sunday 10:00 AM to 4:00 PM, located at Banani, Bangladesh Dhaka. Appointments for the Optometrist consultation must be scheduled at least 24 hours in advance.
- This Quotation Estimate is non-transferable and is prepared exclusively for the named client. Any modifications to the scope of services require a revised Quotation Estimate issued by our office.
- In the event of any dispute regarding services rendered, the parties agree to resolve matters through amicable negotiation. If unresolved, the matter shall be subject to the jurisdiction of the courts in Dhaka, Bangladesh.
Dr. Nusrat Jahan
BOA License No. BOA/2015/0089
ClearSight Optometry & Vision Care Centre, Dhaka Authorized Signatory
Mr. Rafiqul Islam
Managing Director
ClearSight Optometry & Vision Care Centre Client Acceptance
Mr. Abdul Karim Sheikh
Date: _______________
This Quotation Estimate document was generated by ClearSight Optometry & Vision Care Centre, Banani, Bangladesh Dhaka. Document Ref: QE/2025/00847 | Page 1 of 1
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