Patient Name

Doctor
MRN
Age
Sex
S No Details
Stay Ultra Deluxe
Single
Bedded
Two
Bedded
Four
Bedded
3 LSCS 3 Days 88,000 79,000 74,000 70,000
NOTE:
Signature of Patient / Companion Signature of Finance Executive
Name
Relationship with the patient (in case of Companion)
THE ABOVE MENTIONED COST IS ONLY AN ESTIMATE AND THE ACTUAL AMOUNT
PAYABLE MAY INCREASE/DECREASE BASED ON THE UNANTICIPATED CO-MORBID
CONDITIONS
6. In case of High Risk surgeries / procedures a 15% of extra charges will be charged on doctors,
operation theatre and anesthesia charges.
7. Please note nursery cot charges and daily nursing charges will be charged
for baby daily.
* For a normal baby care the estimated cost will be around Rs.15,000/-
Check out time: 12:00 Noon (if discharged after 2:00pm-1/2 day, and after 6:00pm 1 day extra room
charges will be charged)
* If tubectomy is opted with LSCS, it may cost approximately around 10,000/-
**KINDLY NOTE THIS IS NOT APPLICABLE IN CASE OF INSURANCE.
62,000
1. This estimate is based on the number of days of stay as indicated above. Hence, in the event of
complications or an unanticipated extended stay, actual costs may be higher.
2. In the presence of co-morbid conditions, the estimate may increase based on actual cost of
investigations and treatment.
3. In case of Multispecialist references the estimation would vary.
4. The amounts mentioned above are exclusive of applicable taxes.
5. All surgeries / procedures done after 8:00pm, before 8:00am and on Sundays & Holidays will
be charged 25% extra on doctors, operation theatre and anesthesia charges.
2 NORMAL DELIVERY WITH EPIDURAL 2 Days 79,000 68,000 66,000
Room Type
1 NORMAL DELIVERY WITHOUT EPIDURAL 2 Days 74,000 63,000 61,000 58,000
Estimate for Non Package Procedures
DELIVERY ESTIMATES