SIMPLIFIED TAX INVOICE

‫ﻓﺎﺗورة ﺿرﯾﺑﯾﺔ اﻟﻣﺑﺳطﺔ‬

NO:# 1199407 ‫ رﻗم اﻟﻔﺎﺗورة‬Invoice Date Ebrahim Mohammad Almana and Brothers Company
2023-02-01 06:51 PM ‫اﻟﺗﺎرﯾﺦ‬ ‫ﺷرﻛﺔ اﺑراھﯾم ﷴ اﻟﻣﺎﻧﻊ و اﺧواﻧﮫ‬
VAT Number : 300437958200003 ‫رﻗم ﺗﺳﺟﯾل ﺿرﯾﺑﺔ اﻟﻘﯾﻣﺔ اﻟﻣﺿﺎﻓﺔ‬

Patient Name : KHURSHID RABBANI YAQUB ‫اﺳم اﻟﻣرﯾض‬

Patient No. 0050013650 ‫رﻗم اﻟﻣﻠف‬
Age/Gender : 45 Years/Male ‫اﻟﻌﻣر\اﻟﺟﻧس‬
Payment Mode : Cash ‫طرﯾﻘﺔ اﻟدﻓﻊ‬
Nationality : INDIAN ‫اﻟﺟﻧﺳﯾﺔ‬ TOTAL DUE
Company : 59555-GLOBEMED ARABIA-SEDER ‫اﻟﺷرﻛﺔ‬
GROUP COMPANY
‫اﻻﺟﻣﺎﻟﻲ اﻟﻣﺳﺗﺣﻖ‬
Company ID :
Encounter No.
22000095
2548345
‫رﻣز اﻟﺷرﻛﺔ‬
‫رﻗم اﻟزﯾﺎرة‬
SAR 308.08
Speciality : CARDIOLOGIST ‫اﻟﺗﺧـﺻص‬
Doctor : 4002-AMJAD KAMAL ‫اﺳم اﻟدﻛﺗور‬

Code Description Unit(s) Unit Cost Discount VAT% VAT Total (including
‫رﻣز‬ ‫وﺻف‬ ‫وﺣدة‬ ‫ﺗﻛﻠﻔﺔ اﻟوﺣدة‬ ‫ﺧﺻم‬ ‫ﻧ ﺳ ﺑﺔ‬ amount VAT)
‫اﻟﺿرﯾﺑﺔ‬ ‫ﺿ ر ﯾ ﺑﺔ‬ ‫اﻟﻣﺟﻣوع )ﺷﺎﻣل ﺿرﯾﺑﺔ اﻟﻘﯾﻣﺔ‬
‫)اﻟﻣﺿﺎﻓﺔ‬
230026 CHOLESTEROL TOTAL 1 104.34 SAR 0.00 15 2.87 22.50 SAR
SAR SAR

230034 CREATININE 1 104.34 SAR 0.00 15 2.87 22.50 SAR

SAR SAR

230044 FBS (FASTING BLOOD 1 104.34 SAR 0.00 15 2.87 22.50 SAR
SUGAR) SAR SAR

230054 HBAIC - GLYCOSELATED 1 433.37 SAR 0.00 15 11.93 93.46 SAR

HAEMOGLOBIN SAR SAR

230056 HDL ( HIGH DENSITY 1 192.60 SAR 0.00 15 5.30 41.54 SAR
LIPOPROTEIN ) SAR SAR

230057 LDL ( LOW DENSITY 1 192.60 SAR 0.00 15 5.30 41.54 SAR
LIPOPROTEIN )- SAR SAR
MEASURED

230084 SGPT/ALT 1 104.34 SAR 0.00 15 2.87 22.50 SAR

SAR SAR

230090 TRIGLYCERIDES 1 192.60 SAR 0.00 15 5.30 41.54 SAR

SAR SAR

Cash Amount : 308.08 SAR ‫)اﺟﻣﺎﻟﻲ )ﻏﯾر ﺷﺎﻣل ﺿرﯾﺑﺔ اﻟﻘﯾﻣﺔ اﻟﻣﺿﺎﻓﺔ‬
Discount : 0.00 SAR ‫ﺧﺻم‬
Total Excl. VAT : 308.08 SAR ‫اﻻﺟﻣﺎﻟﻲ اﻟﺧﺎﺿﻊ ﻟﻠﺿرﯾﺑﺔ) ﻏﯾر ﺷﺎﻣل‬
‫)ﺿرﯾﺑﺔ اﻟﻘﯾﻣﺔ اﻟﻣﺿﺎﻓﺔ‬
Total VAT : 39.31 SAR ‫ﻣﺟﻣوع ﺿرﯾﺑﺔ اﻟﻘﯾﻣﺔ اﻟﻣﺿﺎﻓﺔ‬
Almana General Hospitals by https://almanahospital.com.sa/
(Saudi Riyals Three Hundred and Total amount 308.08 SAR ‫اﺟﻣﺎﻟﻲ اﻟﻣﺑﻠﻎ اﻟﻣﺳﺗﺣﻖ‬
Ebrahim Mohammad Almana and Brothers Company Phone 0133412000 : ‫ ھﺎﺗف‬Fax 0133417794 : ‫ﻓﺎﻛس‬
Eight and 8.00/100 Halala) due :
VAT #: 300437958200003 Address ‫ ﻋﻧوان‬: King Saud St, Al Khobar Al Shamalia, Al
Khobar 34427
Khobar 34427