Name : Mrs.

ANURADAHA KUMARI MODI Bill No :ZSMH-OPD-00001

Age/Gender : 35 Y F Bill/Reg Date : 03.06.2022
Contact No : +917979767236 Referal Doctor :
Address : 47 PURULIA RD KUMHAR TOLI RANCHI Center : Ranchi
UHID : ZMSH.0000000001

# Department Service Name Qty Rate Discount Amount

1 REG CHARGE OPD 1 100.00 000.00 100.00

Payments Receipt No Mode Amount Bill Amount: 100.00

Settlement Total Discount: 000.00

21-02-2022 ZSMH-OPD-01 UPI Payments Net Payment: 100.00

Authorized Signature :( SWITI KUMARI )