Quotation Estimate Surgeon in India New Delhi –Free Word Template Download with AI
Professional Surgeon Services — India New Delhi
Aravinda Medical & Surgical Services Pvt. Ltd.
Dear Mr. Sharma,
Thank you for your inquiry regarding the professional services of a qualified Surgeon for the planned surgical procedure at our facility located in India New Delhi. This Quotation Estimate has been carefully prepared to provide you with a comprehensive and transparent breakdown of all costs associated with the surgical intervention, pre-operative consultations, inpatient care, and post-operative follow-up. We at Aravinda Medical & Surgical Services Pvt. Ltd. are committed to delivering the highest standard of surgical care in the India New Delhi region, and this document serves as our formal Quotation Estimate for your review and approval.
1. Scope of Services – Surgeon EngagementThe following Quotation Estimate covers the complete engagement of a senior Surgeon (MBBS, MS, MCh – General & Laparoscopic Surgery) registered with the Medical Council of India (MCI) and the Delhi State Medical Council. The Surgeon will be available for all phases of the surgical procedure, including pre-operative assessment, the operative procedure itself, immediate post-operative monitoring, and scheduled follow-up visits. All services are to be rendered at our NABH-accredited surgical centre in Hauz Khas, India New Delhi.
2. Itemized Cost Breakdown| Sr. No. | Description of Service | Quantity | Rate (INR) | Amount (INR) |
|---|---|---|---|---|
| 1 | Pre-operative consultation with the Surgeon (includes history, physical examination, and discussion of surgical plan) | 1 Session | 2,500 | 2,500 |
| 2 | Pre-operative diagnostic investigations (complete blood count, coagulation profile, ECG, chest X-ray, abdominal ultrasound, and anaesthesia fitness assessment) | 1 Package | 8,500 | 8,500 |
| 3 | Surgical procedure – Laparoscopic Cholecystectomy performed by the Surgeon (includes anaesthesia, operating theatre charges, surgical instruments, and consumables) | 1 Procedure | 1,25,000 | 1,25,000 |
| 4 | Inpatient hospital stay – Private single-occupancy room with 24-hour nursing care (estimated 2 nights post-surgery in India New Delhi facility) | 2 Nights | 12,000 | 24,000 |
| 5 | Post-operative medications, dressings, and wound care supplies | 1 Package | 5,500 | 5,500 |
| 6 | Post-operative follow-up visits with the Surgeon (Day 3, Day 7, and Day 14 post-discharge) | 3 Visits | 1,500 | 4,500 |
| 7 | Post-operative diagnostic review (wound assessment, suture removal, and final discharge clearance by the Surgeon) | 1 Session | 3,000 | 3,000 |
| 8 | Emergency on-call availability of the Surgeon for 30 days post-discharge (included in the Quotation Estimate) | 30 Days | 0 | 0 |
| Subtotal (INR) | 1,73,000 | |||
| GST @ 18% (as applicable under Indian healthcare tax regulations) | 31,140 | |||
| Grand Total (INR) | 2,04,140 | |||
The Surgeon assigned to your case, Dr. Anil Verma, holds over 18 years of surgical experience and has performed more than 4,000 laparoscopic procedures. He is a Fellow of the Association of Laparoscopic Endoscopic Surgeons of India (FELSI) and a member of the Delhi Medical Association. The surgical facility in India New Delhi is NABH-accredited, equipped with state-of-the-art laparoscopic towers, C-arm imaging, and a dedicated recovery unit. All surgical instruments are sterilized in-house following WHO-recommended protocols.
4. Terms & Conditions of This Quotation Estimate- This Quotation Estimate is valid for a period of 30 days from the date of issue. Beyond this period, rates may be revised due to changes in consumable costs, hospital tariffs, or regulatory updates in India New Delhi.
- The total amount of INR 2,04,140 (Two Lakh Four Thousand One Hundred and Forty Indian Rupees) is payable as follows: 50% advance (INR 1,02,070) at the time of booking the surgical slot, and the remaining 50% (INR 1,02,070) to be settled within 48 hours of discharge.
- Payment may be made via bank transfer, demand draft, or major credit/debit cards. A receipt will be issued for every transaction.
- In the event of surgical complications requiring extended hospitalization, additional ICU charges, or a conversion to open surgery, a supplementary Quotation Estimate will be presented to the patient or their authorized representative for written consent before any additional procedure is undertaken.
- The Surgeon reserves the right to modify the surgical approach (e.g., from laparoscopic to open) if intra-operative findings necessitate a change in technique for the safety of the patient. This will be communicated to the patient's family immediately.
- All medical records, operative notes, and discharge summaries will be provided to the patient upon discharge. Digital copies may be requested at no additional cost.
- This Quotation Estimate does not include the cost of pre-existing condition management, blood transfusions (if required), or any pathology tests beyond those listed in Item 2.
- Any cancellation of the scheduled surgery by the patient more than 72 hours before the procedure will result in a 10% cancellation fee on the advance amount. Cancellations within 72 hours will be non-refundable.
- All services are subject to the prevailing medical and surgical regulations of the Government of India and the Delhi State Health Authority. The Surgeon and facility comply with all applicable laws and ethical guidelines.
- Disputes, if any, arising from this Quotation Estimate or the services rendered shall be subject to the exclusive jurisdiction of the courts in India New Delhi.
By signing below, the patient or authorized representative acknowledges having received and reviewed this Quotation Estimate for the Surgeon's services in India New Delhi, and agrees to the terms and conditions outlined above. The patient confirms that all relevant medical history has been disclosed and that the surgical plan has been explained in understandable terms.
For Aravinda Medical & Surgical Services Pvt. Ltd.Authorized Signatory / Surgeon
Dr. Anil Verma, MCh (Laparoscopic Surgery)
Reg. No.: MCI/NDL/2007/4521 Patient / Authorized Representative
Name: ___________________________
Signature & Date: _______________ ⬇️ Download as DOCX Edit online as DOCX
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