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VIBRANT HOSPITAL MEDICINE REQUISITION

HEALTHY COLOURSOF LIFE
HOSPITAL
CENTRE &MULTISPECIALITY
ADVANCED NEURO SERGERY-TRAUMA

ANan lCua
Pt. Name:
Dr. Name :
:22i|2.
Date :

Unit. IP No.

Sr. Medicines

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T. Aexiclaw (f2s) hodie
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Nurse's Sing

Emp. I.D. : DsSignature

VIBRANT HOSPITAL, Beside Arbuda Bhavan, Near Dudhsagar Dairy, Gurudwara Road,
Mehsana Palanpur Highway, Mehsana 384002 | Ph:70970 30130
 BILL OF SUPPLY CASH MEMO SUBJECT TO MEHSANA JURISDICATION
VIBRANT PHARMACY MOBILE: 70970 30230, 70970 30130. DL NO -20B 175195,218 175196
NR ARSDABH4VAN-DUOH SAGAR DAIRY, GURUDWARA ROAD, ORIGINAL Page:1of 1 MOBILE: 70970 30230, 70970 30130.
ENSANADAANUR HIGHWAY, EHSANA-384002
Custame : ANJANKUMAR Area: ER Bill No :D21363 22/01/2023 12:27
Datar DR NISHANT CHAUDHARY Area: Mobile

S Doscnptn HSN Code BatchNoExpDt Qty Rate GrossAmt Disc Amount

E002 12/25 1 185.00 185.00 0.00 185.00
1 ANW 3525 30
2 DISPO5 3005 2208097 08/27 1 9.00 9.00 0.00 9.00
3 GLOVES MUL-L 02/25 4 12.00 48.00 0.00 4800
4 GAUE SMALL 3004 112 07/25 1 55.00 55.00 0.00 55.00
5 GERICLAV 625 TAS 3004 MFLAFO9 08/24 10 22.00 220.00 0.00 220.00
6 UNOPAN DSR (CAP) 300490 C21012 07124 10 3.90 39.00 0.00 39.00
7 F-YON SP TABLET 3004 22RTO664 06/24 10 7.40 74.00 0.00 74.00

37 630.00 0.00 630.00

OTHER + 0.00
ROUND OFF 0.00
GST NO 24D0OPW15¬3F1ZT
E.&0. E. NET 630.00
Rupees Sux Hundred Thirty Only
Sotware by V.SAL NFOSOFT PVT. LTD.:Customer Care No: 079 3520 7999
 VIBRANT HOSPITAL
Beside Arbuda Bhavan, Near Dudh Sagar Dairy,
Gurudvara Road, Mehsana-Palanpur Highway
Mehsana. Contact No- 7097030130
OPD BILL
:VH22/9185 Bill. No VHO22/22021
UH
Pa: : ANJANKUMAR BillDate 22/01/2023 12:24:00
Co bor :7574837S45 Consultant Name : DR.NISHANT CHAUDHARI
: 29Yrs /M Ref. Dr.

Rate Qty Amount

Description
3500.00 1 3500.00
Charge
1 3500.00

Net Amount: 3,500.00

Receivable Amount : 0.00

USAND FIVE HUNDRED Only For Vibrant Hospital

A4-22/01/23 12.24 Authorised Signatory

 VIBRANT HOSPITAL
Beside Arbuda Bhavan, Near Dudh Sagar Dairy,
Gurudvara Road, Mehsana-Palanpur Highway
Mehsana. Contact No- 7097030130
OPD BILL
UHID :VH22/9185 Bill. No VHO22/22020
Patient Name :ANJANKUMAR BillDate 22/01/2023 11:07:00
Contact Number :7574837545 Consultant Name VIBRANT HOSPITAL
Age / Gender : 29Yrs /M Ref. Dr.

No Service Description Rate Qty Amount

1 XRAY RT HAND FINGER AP/LT 500.00 500.00
500.00

Net Amnount: 500.00

Receivable Amount: 0.00

FIVE HUNDRED Only For Vibrant Hospital

Remark:

PURSHOTTAM-22/01/23 11.07 Authorised Signatory