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Detailed Receipt

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Agrwal Hospital - 2002 Receipt
MRD No.
125679
Name
John Lorem
Address
2435 Sweetwater, National City, California.
Date of Visit
Jun 23, 2021
ABHA
91-1254-1245-9874
Age
27
Contact No
123-456-789
Discharge
Jun 23, 2021
Gender
Male
Email
pt1@gmail.com
Net Payment
0
Unique ID
91-1254-1245-9874
Treating Doctor
Doctor Agrawal
Mode of Payment
Net banking
# Department Quantity Charges GST
1 IPD 1 2,500 250
2 Admission 5 5,500 550
3 Lab 3 3,000 300
4 Radiology 4 4,500 450
5 Skin 7 7,500 750
6 ENT 9 10,000 1,000
7 Ophthalmology 4 11,000 1,100
8 Delivery 6 7,000 700
9 Gynecology 2 5,000 500
10 IPD 6 8,500 850
11 Ward 6 8,500 850
12 OT 3 5,000 550
13 Anaesthesia 7 9,000 900
14 Other service 6 6,500 600
15 Surgery 7 9,000 900
16 Orthopedic 1 2,000 200
17 Total 84 86,000 8,000
Advance Paid
0
Net Expenditure
0
Payble/Refundable
0
Balance Amount
0
Total Payment
0
Insurance Claim
0
Discount
0
GST
0
Mode of payment
Online
Insurance Company
Company Name
After Discount
0
Total
0
Transuction ID
6824AJH5669
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