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  • In Patient Final Bill: MR No Ip No PT Name Phone No Gender Room DOA DOD

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    santhureddy
    22 views3 pages
    This document is a patient's final bill from a hospital stay which includes the patient's details, dates of admission and discharge, a breakdown of costs for accommodation, consultations, procedures, pharmacy, and lab services, and the total amount owed. It also includes procedure details and an itemized total billed amount with approvals and amount due in words.

    Original Description:

    HOSPITAL BILLING FORMAT

    Original Title

    Bill Format

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    This document is a patient's final bill from a hospital stay which includes the patient's details, dates of admission and discharge, a breakdown of costs for accommodation, consultations, procedures, pharmacy, and lab services, and the total amount owed. It also includes procedure details and an itemized total billed amount with approvals and amount due in words.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    22 views3 pages

    In Patient Final Bill: MR No Ip No PT Name Phone No Gender Room DOA DOD

    Uploaded by

    santhureddy
    This document is a patient's final bill from a hospital stay which includes the patient's details, dates of admission and discharge, a breakdown of costs for accommodation, consultations, procedures, pharmacy, and lab services, and the total amount owed. It also includes procedure details and an itemized total billed amount with approvals and amount due in words.

    Copyright:

    © All Rights Reserved
    Download as XLSX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 3

    IN PATIENT FINAL BILL

    MR NO IP NO
    PT NAME PHONE NO
    GENDER ROOM
    DOA DOD

    FROM TO NO PER
    SNO SERVICE DATE DATE UNITS UNIT TOTAL AMOUNT

    1 ACCOMMODATION
    ICU ₹ 0.00
    DELUXE ROOM ₹ 0.00
    ACCOMMODATION AMOUNT ₹ 0.00
    2 CONSULTATIONS
    DR. CHANDRA SHEKAR REDDY
    (GENERAL PHYSICIAN) ₹ 0.00
    CONSULTATIONS AMOUNT ₹ 0.00
    3 SUPPORTIVES
    NEBULIZATION

    GRBS

    SUPPORTIVES ₹ 0.00
    4 PHARMACY (Details enclosed) ₹ 0.00

    5 LABORATORY(Details enclosed) ₹ 0.00


    TOTAL AMOUNT ₹ 0.00
    INTIAL APPROVAL ₹ 0.00
    BALANCE TO BE APPROVAL ₹ 0.00

    in words:
    FINAL BILL DETAILS

    PATIENT NAME AGE/SEX IP NO

    DOA DOS DOD

    PROCEDURE AGREED DELUXE ROOM PACKEGE FOR LAP


    SL NO: 24 APPENDECTOMY

    AGREED DELUXE ROOM PACKEGE FOR OVARIAN


    PROCEDURE CYSTECTOMY FOR 50% OF PACKEGE AMOUNT
    SL NO: 56

    TOTAL BILLED AMOUNT


    INTIAL APPROVED
    DUE AMOUNT

    IN WORDS:

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