Quotation Estimate Surgeon in Bangladesh Dhaka –Free Word Template Download with AI
Professional Surgeon Services — Bangladesh Dhaka
Ref: QE/BD/DHK/2025/0472
1. Purpose of This Quotation EstimateThis Quotation Estimate is prepared by Dhaka Advanced Surgical Centre to provide a comprehensive and transparent cost breakdown for the engagement of a qualified Surgeon for planned surgical procedures. This document serves as a formal Quotation Estimate for the client residing in Bangladesh Dhaka, outlining all professional fees, facility charges, and ancillary costs associated with the surgical intervention. The Surgeon referenced in this Quotation Estimate is a board-certified specialist registered with the Bangladesh Medical and Dental Council (BMDC) and holds over fifteen years of clinical experience in general and laparoscopic surgery within the Dhaka metropolitan area.
2. Scope of Surgeon ServicesThe Surgeon engaged under this Quotation Estimate will provide the following professional services in Bangladesh Dhaka:
- Pre-operative consultation, physical examination, and diagnostic review (including blood work, imaging interpretation, and anaesthesia assessment) conducted at the Dhaka Advanced Surgical Centre facility in Banani, Dhaka.
- Performance of the primary surgical procedure, including all intra-operative decision-making, instrument handling, and tissue management by the lead Surgeon and assisting surgical team.
- Post-operative monitoring for a minimum of 48 hours within the hospital ward, with the Surgeon conducting at least two in-person follow-up examinations during the recovery period.
- Two scheduled post-operative review appointments (at 7 days and 30 days post-surgery) to assess wound healing, suture removal, and overall recovery progress.
- Emergency contact availability for the Surgeon for a period of 14 days following discharge, accessible via the hospital's dedicated Dhaka-based helpline.
- Provision of a detailed surgical report, operative notes, and discharge summary in both English and Bangla for the patient's medical records.
| # | Description of Service / Item | Quantity | Unit Price (BDT) | Amount (BDT) |
|---|---|---|---|---|
| 1 | Surgeon Professional Fee — Pre-operative Consultation & Diagnostic Review | 1 session | 8,500 | 8,500 |
| 2 | Surgeon Professional Fee — Primary Surgical Procedure (Laparoscopic Cholecystectomy) | 1 procedure | 1,25,000 | 1,25,000 |
| 3 | Surgeon Professional Fee — Intra-operative Anaesthesia Coordination & Monitoring | 1 session | 18,000 | 18,000 |
| 4 | Surgeon Professional Fee — Post-operative Ward Monitoring (48 hours) | 2 days | 12,000 | 24,000 |
| 5 | Surgeon Professional Fee — Post-operative Review Appointments (Day 7 & Day 30) | 2 visits | 5,000 | 10,000 |
| 6 | Surgeon Professional Fee — 14-Day Emergency Helpline Availability | 14 days | 1,500 | 21,000 |
| 7 | Hospital Facility Charges — Private Single Room (2 nights in Dhaka) | 2 nights | 15,000 | 30,000 |
| 8 | Surgical Consumables, Implants & Disposables | 1 set | 35,000 | 35,000 |
| 9 | Pre-operative Laboratory Tests & Diagnostic Imaging (Ultrasound, X-ray, Blood Panel) | 1 package | 12,500 | 12,500 |
| 10 | Pharmaceuticals & Post-operative Medication (30-day supply) | 1 course | 8,000 | 8,000 |
| 11 | Administrative & Documentation Fees (Surgical Report, Discharge Summary, BMDC Compliance) | 1 set | 3,500 | 3,500 |
| Subtotal (BDT) | 2,95,500 | |||
| VAT @ 5% (Applicable in Bangladesh) | 14,775 | |||
| Grand Total (BDT) | 3,10,275 | |||
- Advance Payment (50%): BDT 1,55,137.50 to be paid at the time of accepting this Quotation Estimate, prior to scheduling the Surgeon's availability.
- Balance Payment (50%): BDT 1,55,137.50 to be settled within 7 calendar days of the patient's discharge from the Dhaka facility.
- Accepted payment methods: Bank transfer (Dutch-Bangla Bank, Sonali Bank, or BRAC Bank Dhaka branch), mobile banking (bKash, Nagad), or certified cheque.
- A 2% late-payment surcharge will apply to any balance outstanding beyond the 7-day window specified in this Quotation Estimate.
- This Quotation Estimate is valid for a period of thirty (30) calendar days from the date of issue. Beyond this period, all Surgeon fees and facility charges are subject to revision based on prevailing rates in Bangladesh Dhaka.
- The Surgeon reserves the right to modify the surgical approach intra-operatively if clinical findings necessitate a change in technique. Any additional costs arising from such modifications will be communicated to the patient's authorized representative prior to implementation and will be itemized in a supplementary Quotation Estimate.
- All services described in this Quotation Estimate will be rendered at the Dhaka Advanced Surgical Centre, Banani, Dhaka, Bangladesh. The facility operates in compliance with the Bangladesh Medical and Dental Council regulations and the Department of Health Services, Government of Bangladesh.
- The Surgeon and the hospital are not liable for complications arising from pre-existing conditions not disclosed during the pre-operative consultation. The patient is required to provide a complete and accurate medical history.
- This Quotation Estimate does not constitute a guarantee of surgical outcome. All surgical procedures carry inherent risks, which will be discussed in detail during the pre-operative consent meeting.
- Any cancellation by the client after the Surgeon's schedule has been confirmed will incur a non-refundable fee of BDT 25,000 to cover the Surgeon's reserved time and preparatory work.
- Disputes arising from this Quotation Estimate shall be governed by the laws of the People's Republic of Bangladesh and shall be subject to the exclusive jurisdiction of the courts in Dhaka.
The Surgeon assigned to this case holds the following credentials: MBBS (Dhaka Medical College, Bangladesh), MS (Surgery, National Institute of Diseases, Dhaka), Fellowship in Laparoscopic Surgery (Royal College of Surgeons, Edinburgh), and is currently registered with the Bangladesh Medical and Dental Council (Registration No: BMDC/2009/4471). The Surgeon has performed over 3,200 surgical procedures in Bangladesh Dhaka and is affiliated with the Dhaka Medical Association and the Bangladesh Association of Surgeons.
For Dhaka Advanced Surgical Centre
Dr. Kamrul Hasan Chowdhury, MS (Surgery)Lead Surgeon & Medical Director
Date: _______________
Client Acknowledgement
Mr. Rahim Uddin AhmedPatient / Authorized Representative
Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
Create your own Word template with our GoGPT AI prompt:
GoGPT