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UHID 55378 IP Number IP20/52

Patient Name Mrs Rasmeena Admission Date Time 17-11-2020 03:02:19 PM


Age / Gender 54 Y/Female Discharge Date Time 17-11-2020 06:53:28 PM
Patient Address 2GurugramHaryana Bill Number IPB45
Bill Date Time 17-11-2020 06:54:08 PM Admitting Doctor Dr Asif Mir
Bed No. / Billing Category 206B/ Treating_doctor Dr Asif Mir
Payer Type cash Payer Name Self

IP FINAL BILL(Summary) (Amount in Rs)


S.N Service Group Amount Discount Bill Amount
1 Procedure 26,914.08 965.92 27,880.00
2 Administration 11,333.46 416.54 11,750.00
3 Radiology 1,475.76 54.24 1,530.00
4 IP Consultation 7,716.40 283.60 8,000.00
5 Pharmacy and Consumable 5,597.61 207.03 5,804.64

6 Pathology 1,572.22 57.78 1,630.00


7 Cardiology 405.11 14.89 420.00

Payment Details:
S.N Date & Time Mode Receipt No Amount Transaction Type
1 17-11-2020 06:54:08 cash IPB45 50,000.00 PAID SETTLEMENT
PM
2 17-11-2020 06:55:29 paytm IPR87 5,015.00 DUE SETTLEMENT
PM

Total Amount 57014.64


Discount 2000.0
Net Amount 55014.64
Round Off 0.36
Paid Amount 55015.0

Patient Attendant signature Printed By Created By


Rasmeena Anandita Verma

(*********** Electronically Generated Report ***********)

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