Final Bill

Pravat Behura
24 Y M
Cuttack, Odisha
GENERAL MEDICINE & CARDIOLOGY
Dr Gautam Sarkar
ICU8
Hospital Generated

Name:
Age/Sex :
Address :
Department:
Doctor:
Bed Type:
Referred By:

Charges

Head

Description

Doctor Charges
22-08-2015
22-08-2015

Doctor Visit Charges

ICU Team Fees

Dr Gautam Sarkar
Hospital Team

Registration
22-08-2015

Bill No:
Bill Date:
MR No:
Visit ID:
Admission Date:
Discharge Date:
Rate Plan:

Documents And Diet

Management

BLA23196
26-08-2015
MR076958
IP020983
22-08-2015 15:22
26-08-2015 15:30
GENERAL

Qty

Disc

Amount

1,350.00
200.00
Sub Total:

0.00
0.00

1,350.00
200.00
1, 550.00

1,075.00

0.00

1,075.00

Rate

Sub Total:
ICU Charges
22-08-2015

ICU BED CHARGES

330A
(22-08-201515:15 to 26-08-201512:00)

3,200.00

1,075.00
0.00

Sub Total:
Diagnostics
22-08-2015
22-08-2015
22-08-2015
22-08-2015
22-08-2015
22-08-2015
22-08-2015
22-08-2015
22-08-2015
22-08-2015
22-08-2015
22-08-2015
22-08-2015

Lab Tests Charges

Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges

23-08-2015
23-08-2015
23-08-2015
23-08-2015
23-08-2015
23-08-2015

Lab Tests Charges

Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Lab Tests Charges
Radiology Tests Charges

Services &
Procedures
22-08-2015

Services And Procedure

Charges

Serology Profile(IPD)
CREATININE
Potassium(K)
Sodium(Na)
UREA
ABG - Blood Gas Analysis
HB TC DC
Calcium
Liver Function Test
AMYLASE
LIPASE
Urine RE
(Report
After 3 Culture And Sensitivity(MIC)
Days]
Potassium(K)
UREA
CREATININE
Sodium(Na)
Tc Dc
Usg Whole Abdomen

Initial Managemtcharge

3,200.00
3,200.00

1,575.00
320.00
380.00
380.00
320.00
1,250.00
230.00
280.00
1,200.00
610.00
675.00
200.00
1,000.00

0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00
0.00

1,575.00
320.00
380.00
380.00
320.00
1,250.00
230.00
280.00
1,200.00
610.00
675.00
200.00
1,000.00

380.00
320.00
320.00
380.00
190.00
2,250.00
Sub Total:

0.00
0.00
0.00
0.00
0.00
0.00

380.00
320.00
320.00
380.00
190.00
2,250.00
12,260.00

0.00

450.00

450.00
Sub Total:

450.00

Sub Total:

55.00

Other Charges

Medicines & Consumables

22-08-2015
Pharmacy Sales
22-08-2015

Pharmacy Sales

22-08-2015

Pharmacy Sales

Pharmacy sales bill

(No. SB282252)
Pharmacy sales bill
(No. SB282253)
Pharmacy sales bill
(No. SB282323)

893.47

0.00

893.47

996.72

0.00

996.72

2,224.26

0.00

2,224.26

Sub Total:

4,114.45

Service Charges

Report delivery time :7.00 p.m To 8.30 p.m (Report to be collected within one month)
Booking in advance does not ensure any bed category at the time of admission
Advance booking amount not refundable

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