20 Al Taka St.

Behind Ahli Club , Nasr

city

Outpatient Claim ID : 1245347

xceed
Amir Imam El Dien Kamel Abd El Halem
Staff ID: 27872
Card Number: Actual Date: 02/10/2021
0Co-Payment %: Service Name: Dental

Copy Amount 0
‫ﻻ ﻳﺘﻢ ﺍﺭﺳﺎﻝ‬ Provider Name: ‫ﻀﻪ‬
‫ﺍﻧﺘﻬﺎﺀ ﺟﻤﻴ‬

Dental
MedicalCaries
Icd

Medical Diagnoses Memo Medical Proc. / DrugConcentration Pack Size Qty

‫ﺍﻟﺘﺸﺨﻴﺺ ﺍﻟﻄﺒﻰ‬ ‫ ﺍﻟﻌﻼﺝ‬/ ‫ﺍﻻﺟﺮﺍﺀ ﺍﻟﻄﺒﻰ‬ ‫ﺍﻟﺘﺮﻛﻴﺰ‬ ‫ﺍﻟﻜﻤﻴﺔ‬

K02. ‫ﺍﻟﻜﺸﻒ‬ 1

bassam.mohamed /‫ﺩﻛﺘﻮﺭ‬ ‫ﺗﻮﻗﻴﻊ ﺍﻟﻤﺴﺘﻔﻴﺪ‬

2726625021101245347

02-10-2021 17:13:24

Valid for 10
‫ﺳﺎﺭﻯ ﺣﺘﻰ‬ 10