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HEALTHCARE
Super Speciality Hospital
Interim Inpatient Bill (Summary)

IPIO 157475
MaxID EHPG.000044807
Patient
Mr . vishesh raj yadav Bill Date 27/04/2017 13:45
Bed 16050
Admit 22/04/)0l 719; 14
Doctor
BS Murthy (Ortho Un1t2) Discharge 27/04/2017 13;05
Age/ Sex 78 Year(sl/ Male

C.I ... ,,. ""'rvic:e l't"IT'f' Amount(Rs.)

1 Cardiology Services 320.00

Consultations 950 00
Consumables 384.00
4 drugs 8.797.24
Laboratory Services I 7,590.00
6 Medical Consumables 36,461.9�
7 Other Charges 500.00
Physiotherapy 300.00
Radi ology Services 4,570 00
10 Room Rent 11,000.00

Deposit Details : Grand Total 70,873.18

SNo. Date ReceiptNo Amount

1 22/04/2017 TDP30425 15,000.00 Bill Amount 70,873.18

Total Deposit Amount : 15,000.00 Deposit 15,000.00

Arnounttobepaid by patient 55,873.00

Bill Status Paid

Dat.e 27/04/2017

Sandeep Kumar Sharma

Patient Care Coordinator

P>nn,tDate ·-27/4/2017 - .IPID..: -�47.5. ----------- Page 1 d

. . Max Super Speciality Hospital )(XI 0f 1860)

A unit of Balaj, Medic al and Diagno stic Research Centre (R ister ed under the Societies Regi stration Act
Regd. Office: 10B A, lndraprastha Ex��nsion, Patparganj, Delhi - 110092
P h one: +91 11 4303 3333 Fa": +91 11 2223 5563
www.maxhealth�a re.in