Redoble Medical Clinic

Buug, Zamboanga Sibugay

January 29, 2008

STATEMENT OF ACCOUNT

NAME: Quintero Jesly AGE: 7 SEX: Female STATUS: Single

Address: Danlugan Buug Zamboanga Sibugay

Date of Admission: Jan/ 28 / 08

Date of Discharge: Jan. /29 /08
Admitting Diagnosis: Acute Gastritis

Medicine Unit Amount Total

D5 IMB #1 140.00 140.00
Venoset #1 70.00 70.00
I.V Canula #1 120.00 120.00
Venoclysis #1 150.00 150.00
Metoclopramide amp. #1 140.00 140.00
Cotrimoxazole Sup.. #1 40.00 40.00
Syringe #1 15.00 15.00

PF 800.00
Lodging 400.00

Grand Total: 1,875.00

Dr. Rosendo C. Redoble

Attending Physician