Interim Inpatient Bill (Summary)

IPNo. : 57080 UHID : MSHK.805639

Patient Name : Mr. SUNIL KUMAR GHOSH Admission Date & Time : 01-03-2022 02:04:25

Bed No. : CTVS-18 Age/Sex : 78 Year(s) / Male

Doctor Name : Dr. CTVS(K.Sarkar/M.B.Das/A.Samal/S.Ghosh/S.Kumar)

Company : Hospital Schedule (Nov 2019)

Sl.No. Service Name Patient Amt Company Amt Amount(Rs)

1 REGISTRATION CHARGES 250.00 0.00 250.00

2 ROOM RENT 99750.00 0.00 99750.00

3 CABG 1-(100.00%) 200000.00 0.00 200000.00

4 INSTRUMENT & EQUIPMENT CHARGES 3810.00 0.00 3810.00

5 PROCEDURE CHARGES 22044.00 0.00 22044.00

6 CONSULTATIONS 17000.00 0.00 17000.00

7 RADIOLOGY & IMAGING 14850.00 0.00 14850.00

8 LABORATORY SERVICES 53680.00 0.00 53680.00

9 INVESTIGATIONS 15480.00 0.00 15480.00

10 OTHER PATIENT SERVICE CHARGES 83180.00 0.00 83180.00

11 BLOOD BANK 4800.00 0.00 4800.00

12 FOOD AND BEVERAGES 198.00 0.00 198.00

13 ADMIN CHARGES 17292.00 0.00 17292.00

14 IP Drugs/ Medicine 14780.55 0.00 14780.55

15 IP Surgical Disposable 70191.80 0.00 70191.80

Grand Total : 617306.35 0.00 617306.35

Bill Amount : Rs 617306.35

Deposit : Rs 400000.00

Net Amount to be paid by patient : Rs 217306.35

Print Date : 15/3/2022 14:12:44 Page 1 of 2

 Interim Inpatient Bill (Summary)

IPNo. : 57080 UHID : MSHK.805639

Patient Name : Mr. SUNIL KUMAR GHOSH Admission Date & Time : 01-03-2022 02:04:25

Bed No. : CTVS-18 Age/Sex : 78 Year(s) / Male

Doctor Name : Dr. CTVS(K.Sarkar/M.B.Das/A.Samal/S.Ghosh/S.Kumar)

Company : Hospital Schedule (Nov 2019)

Sl.No. Service Name Patient Amt Company Amt Amount(Rs)

Deposit Details :

SNo. DateTime MOP ReceiptNo. Amount

1 01/03/2022 2:05 DEBIT CARD IPDP83600 80000.00

2 04/03/2022 11:11 CASH IPDP83965 190000.00

3 04/03/2022 11:13 DEBIT CARD IPDP83966 10000.00

4 04/03/2022 11:14 DEBIT CARD IPDP83967 20000.00

5 06/03/2022 17:18 DEBIT CARD IPDP84260 50000.00

6 14/03/2022 17:23 DEBIT CARD IPDP85334 50000.00

Net Deposit Amount : 400000.00

Tamaleena Majumder

Signature Signature of patient/Next of Kin

Print Date : 15/3/2022 14:12:44 Page 2 of 2