Printable Medical Report Invoice

By | November 22, 2011

A medical report invoice template provides the structural indication of framing and submitting a medical report invoice properly. It is created by doctors who work under a hospital and are accountable to the authority. They have to make a compact report of the patient’s problems, the treatments meted out to him, the services required in the process and other vital information. This account is also supplemented with the costs and expenses of the patient as well as the hospital per se. this is important because the authorities have to be informed about the profits and losses of the organization as a whole. Thus the document should be written in a comprehensible manner laying down the required details in the correct format.

You can Download the Free Medical Report Invoice Template form, customize it according to your needs and Print. Medical Report Invoice Template is either in MS Word, Excel or in PDF.

Sample Printable Medical Report Invoice Template

Medical Report Invoice Template

Download Medical Report Invoice Template

MEDICAL REPORT INVOICE TEMPLATE

Date: ______ [Provide date of submission] Bill Number: _______ [Provide number of the invoice] Doctor: ______ [Mention full name of the specialist]
Hospital Name: ________ [Give name of the nursing home]Address: __________ [Give address including street and city]Number: [Give all the working numbers] _________, __________, _________Email: _________ [Give email contact]
PATIENT’S DATA: [Furnish the required information] FILE NUMBER: ________ [Indicate file number of the patient]
Patient’s Name: _______ [Provide name] Ward number: _______ [Provide ward number]
Diagnosis: _________ [Mention the disease name] Bed number: _________ [Provide bed number]
Age: __________ [Provide age] Admission Date: _______ [Indicate date]
Phone: ________ [Provide number] Date of dismissal: _________ [Indicate date]
Address: __________ [Provide address] Attendant: _________ [Mention attendant’s name]

DATE [Mention appropriate date]

SERVICE [Mention service name]

AMOUNT [Mention cost]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature: _______________

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