Mrs. Shrabanti Das was admitted to the oncology department at a hospital on October 30, 2022 and discharged on January 19, 2023. The total bill for her hospital stay was Rs. 13,200, which was paid in full by the patient. The bill includes charges for meals, pharmacy items, consultations, medical records, and other non-medical expenses during her hospitalization for treatment by Dr. Sandeep Nayak.
Mrs. Shrabanti Das was admitted to the oncology department at a hospital on October 30, 2022 and discharged on January 19, 2023. The total bill for her hospital stay was Rs. 13,200, which was paid in full by the patient. The bill includes charges for meals, pharmacy items, consultations, medical records, and other non-medical expenses during her hospitalization for treatment by Dr. Sandeep Nayak.
Mrs. Shrabanti Das was admitted to the oncology department at a hospital on October 30, 2022 and discharged on January 19, 2023. The total bill for her hospital stay was Rs. 13,200, which was paid in full by the patient. The bill includes charges for meals, pharmacy items, consultations, medical records, and other non-medical expenses during her hospitalization for treatment by Dr. Sandeep Nayak.
Mrs. Shrabanti Das was admitted to the oncology department at a hospital on October 30, 2022 and discharged on January 19, 2023. The total bill for her hospital stay was Rs. 13,200, which was paid in full by the patient. The bill includes charges for meals, pharmacy items, consultations, medical records, and other non-medical expenses during her hospitalization for treatment by Dr. Sandeep Nayak.
Pateint Name : Mrs. Shrabanti Das Bill No : 111323IPCR001929
UHID : 12079079 Bill Date : 19-Jan-2023 4:56 PM EpisodeNo : 14864/23/1113 Admitted on : 30-oct-2022 12:01 PM Age/Sex : 38 YEAR(S)/Female Discharged On : Phone No. : 9380637297 Department : ONCOLOGY Address : 69/1 k, cassopoor baranagar, Treating Doctor : Dr. Sandeep Nayak kolkatta , Kolkata. kolkatta Claim No. : RC-HS22-133955586 Place of Supply :
Customer Details Insurance/Corp. : HDFC ERGO GENERAL INSURANCE COMPANY LIMITED
Customer Category : Domestic Insurance Customer Site : NOTA01917Z-KARNATAKA
Customer Name : HDFC ERGO GENERAL INSURANCE COMPANY LIMITED
Customer Address : BANGALORE, 30 DAYS, TPA Name : HDFC ERGO GENERAL INSURANCE COMPANY LIMITED Bangalore 560076, Karnataka, India GSTIN : 03AABCL5045N1ZI
S.No Particulars HSN/SAC Gross Amount Discount Net Final Amount
1 PATIENT MEAL [NM] 999311 3600.00 0.00 3600.00
2 PHARMACY [NM] 999311 4600.00 0.00 4600.00
3 CONSULTATION [NM] 999311 2400.00 0.00 2400.00
4 MRD [NM] 999311 1200.00 0.00 1200.00
5 OTHER NON-MEDICAL EXPENCE 999311 1400.00 0.00 1400.00
BILL AMOUNT : 13200.00 0.00 13200.00
CGST: 0.00 SGST: 0.00 NET BILL AMOUNT : 13200.00 HDFC ERGO GENERAL INSURANCE 0.00 COMPANY LIMITED 0.00 PATIENT SHARE : 13200.00 DEPOSIT BY PATIENT : 13200.00 REFUND AMOUNT 0.00 NET PAYABLE AMOUNT : 0.00
INDIVIDUAL CREDIT 0.00
Closed By : Rajendra V Discharge By : Rajendra V
Patient/Attendant's Sign :
Name : SIDDHARTHA J Relation : SON Phone No : 9380637297
(Note: All original payment receipts required for Final Bill Clearance.
