Adarsh Medical Store Medical INVOICE

Dhanauta, Zamania Qasba Date:

Invoice #: [123456]

PATIENT & HOSPITAL DETAILS

Patient Name: Click here to enter text. Contact:
Patient Age: Consultant: Click here to enter text.
Gender: Click here to enter text. Hospital No: Click here to enter text.
Address: Click here to enter text. Bed No: Click here to enter text.

SR # Description MU QTY PRICE DISCOUNT BALANCE

SUBTOTAL
Notes/COMMENTS/ INSTRUCTIONS TAX RATE
1. TAX
2. (OTHER) SPECIFY
3. (OTHER) SPECIFY
4. TOTAL