Dr. B. Lal Clinical Laboratory Pvt. Ltd.

Girdhar Marg Centre

25-26,Sidharth Nagar-E, Malviya Nagar, Jaipur
Phone: 0141-2724980, Mobile-7357725777,9166125555

BILL OF SUPPLY

Name : MRS. PUSHPA DEVI

Age/Sex : 62 Y 5 M 30 D / FEMALE
Bill No. : DBCL/22-23/8000002584 Lab No. : 0802211000006
Contact No. : 9799033332 Receipt No. : 0802200002527
Reffered By : DR. ASHOK KUMAR SAXENA Date : 01-Nov-2022 10:59:58
Email : Card No : 22S66893
Barcode : 80008928 SAC No : 999316

Particulars Amount (Rs.)

OTHERS
HOME COLLECTION (FREE) (LSHHI12084976) 0.00
CLINICAL-BIOCHEMISTRY
T4 TOTAL (THYROXINE) (SERUM) 150.00
T3 TOTAL (TRI-IODOTHYRONINE) (SERUM) 150.00
Total: 300.00
Discount: -30.00

CHEQUE/DD:: (270) Amount Paid 270.00

Previous Bal: 0.00

Due Amt: 0.00

Received with thanks an amount of (Rupees) Two Hundred Seventy Only
Net Amount 270.00
Remarks : DINESH BAIRWA , PACKAGE BARCODE NO. 80008927

Staff Signature
* test outsourced to ------------lab (NABL Accreditated) and lab will not be responsible for any damage in transportation of this sample.
1. View your reports online at www.blallab.com in the 'Download Your Report' section. Enter following user id and
password after going in 'Download Your Report' section.
User id: LSHHI3951200 Password: 0802211000006
2. In case of due payment, you can pay online at the website post entering User Id and Password.
3. The deposited amount is non-refundable.
4. Sample cannot be collected post 3 days of registration of the customer.
5. The above mentioned rates are applicable for Non-Covid or Non- Mucormycosis patients.

Note: I hereby confirm that the personal details and investigations written are correct and with my consent.

Customer Signature
Dr. B. Lal Clinical Laboratory Pvt. Ltd.
Reg. office: 6-D, Malviya Industrial Area, Malviya Nagar, Jaipur-302017, CIN: U33125RJ1994PTC009129,
Tel: 0141-4045999,Customer Care - +91-9166125555, Email: customercare@blallab.com, Website: www.blallab.com
01-Nov-2022 10:59:58 Prepared By : DINESH BAIRWA

01-Nov-2022 05:40 PM Page 1 of 1