BILL /RECEIPT

Name : Mr. AKSHAN KAMBOJ Visit No. : 86281

Age/Gender : 22 Yrs./Male Visit/Reg. Date : 08/01/2022 14:35:32
Contact No : 8800110164 Refered By : MEDIBIRD DIAGNOSTICS (JP) Scan this code to
Address : 123 MUKHARJEE PARK Center : COVID track your report.
Client Name : MEDIBIRD DIAGNOSTICS (JP) Aadhar No : 301121893769
SRF ID : 0708503136878

# Test Name Barcode Total

1. SARS CoV-2 RT PCR 2110198663 500.00

Bill Amount : 500.00

Settlement Payment Receipt No. Mode Curreny Amount Received By Total Discount : 0.00

Settlement 08/01/2022 CLS-18665 Cash 500.00 Shivani Verma Net Bill Amount : 500.00
Total Paid Amount : 500.00
Balance Amount : 0.00

Received with thanks : Five Hundred

Authorized Signatory