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Anand Kumar Goyal pdf-1

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64 views1 page

Anand Kumar Goyal pdf-1

Uploaded by

rahulgoyal454
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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UHID SJAS-DBD-2608 IP Number SS-IP-691

Patient Name Mr Anand Kumar Goyal Admission Date Time 14-12-2024 06:01 PM
Age/gender 48 Y,9 M,26 D/Male Admitting Doctor DR. AVINASH CHOUDHARY
Interim No SS-INTBL-4227 Admitting Doctor Speciality Orthopaedics
Bed No./Ward Male-02/Economy Ward Treating Doctor Dr M. Junaid Alam
Billing Category General Treating Doctor Speciality ENT
Discharge Date Time 17-12-2024 02:27 PM Referred By
Payer Name CASH Address NIRSA CUM CHIRKUNDA,
Dhanbad,Jharkhand,India

Interim Bill Summary (Amount in Rs.)

S.No. Service Group Bill Amount Net Amount


1 Physiotherapy 550 550
2 Room Rent 15,500 15,500
3 Equipment 2,200 2,200
4 Pharmacy 18,480.67 18,480.67
5 IP Consultation 9,700 9,700
6 Administration 500 500
7 Pathology 10,660 10,660
8 Radiology 13,540 13,540

Payment Details

S.No. Date & Time Receipt No Mode Transaction Type Transaction No Amount
1 14-12-2024 08:19 PM SS-IRCP-2706 Credit Card Deposit 187029 30,000

Total Amount 71130.67


Net Amount 71130.67
Paid Amount 30000.0
Net Advance Amount 30000.0
Due Amount 41130.67

Patient Attendant signature Printed By Created By


Pankaj Kumar Belthoria Bipin Kumar

(********** Electronically Generated Report **********)

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