CARDINAL GRACIAS MEMORIAL HOSPITAL TRUST wu Bangi, Sandor, PO. Voss, DESMA ECS: 0762¢24/7250772424/7350622424/72506I2824 Qe ‘EmallD:egbospiak@yehecon_ Website wwcaralaishosptalcon GSTN 27AAAACDAESRYZA JULIET Patient Copy Patient Details Patient No CGMH23018920 Request No CGOP230075141 Patient Name Mr. Peter B Dcunha Request Date 22-07-2023 12:11:29 Age/Sex 62 Years /Male Bill No CGOBL230075170 Ref By. Bill Date 22-07-2023 12:11:29 Company Patient Category Senior Citizen S.No Service Code Service Name ‘Token No. Rate(Rs)_ Qty Amount (Rs) 1. CGSER120000012 Consultation First Vist Or. Joel Tuscano © 35000 1.00 350.00 Gross Amcunt (Rs) 350.00 ayment Mode Number Bank ‘Amount Sage eae ait | at Papleby Peon | ——_—2500 Net Received From Patient 350.00 ‘Amount in Words: RUPEES Three Hundred Fifty Only. Romarks : Colect A Poncing Investigation Repons/ ey Fis From Depeimet Within 1 Week Fam Oscharge Ota No Rendon Suny Publ Hokdoys apes wil be wie only spins the Race A) CARDINAL GRACIAS MEMORIAL HOSPITAL TRUST. wv Bang Sandor Po. VexBHLL GU. ROGOIBE: yssons2e2u7as07rzezuras0622620735052224 Ss Ell: cgesptlGyatoncom_Webse: wwocrdnachaptl com STN 27AAAACDESSTZA JULIET Patient Copy Patient Details Patient No (CGMH23018920 Request No (CGOP230077451 Patient Name Mr. Peter 8 Dcunha Request Date 29-07-2023 12:14:45 Age!Sex 62 Years / Male Bill No ©GOBL230077480 Ref By. Bill Date 29-07-2023 12:14:45 Company Patient Category Senior Citizen SNo Service Code Service Name Token No. Rato(Rs) Gly Amount (Rs) 1. CGSER120000012 __Consutaon Re-Vist Ox. Joe! Tuscano 43 20000 1.00 200.00 (Gross Amount (Rs) 200.00 No Payment Mode | Number Date Bank Amount TT Cnr 20000 —_Net Payable By Patient 200.00 Net Received From Patient 200.00 ‘Amount in Words: RUPEES Two Hundred Oniy. Remarks Calet Al Pring Investigation Reports /Xay Fis Fram Department Whi 1 Wook Fram Discharge Date No eld on Sunday / Public Hadays apr wil beissud ony agaist the Receipt.Sun Lab. Diagnostics Pvt. Ltd. ‘Gokul Siddhi Building, Gokul Township, C.S. Road Virer(W) ‘Tel:8550993822 / 8530146160 BILL / RECEIPT Name MR. Peter D’cunha Referred by Dr. : M.S. Ayyar - MS Test Histopathology - Small Specimen Received with thanks Sum of Rs. ONE THOUSAND FIVE HUNDRED ONLY. TIMING Monto Sat: 8 am to 7 pm ‘Sunday 8 am to § pm Reports: Mon to Sat: 5 pmto7 pm Sunday : 4 pm to 5 pm "Subject to realisation of cheque.No. Sun Lab. Diagnostics Pvt. Ltd. IPT Date 02/08/2023 BillReceipt No: 2082340 Age 'Sex e3Years / M 1500 Total 1500 ‘Amount Received 7500 Balance oO Discount ==] others 04 For Sun Lab Diag, Pvt Ltd Gokul Siddhi Building, Gokul Township, C.S. Road Virar(W) ‘Tel:8550993822 / 8530146160 BILL RECEIPT Name MR. Peter Deunha Date 30/07/2023 Referred by Dr. : M.S. Ayyar-MS BilvReceipt No: 30072375 Age /Sex 62 Years) M Test CREATININE 200 ‘SGPT. 200 40BC 200 7 BILIRUBIN 200 ‘URINE ANALYSIS 400 " BSR 50 ) BLOOD GROUP & RH FACTOR 100 y HBAIC 500 HIV (Elisa) 350 | HBSAG - ELISA 300 Received with thanks Sum of Rs. Total 2200 TWO THOUSAND TWO HUNDRED ONLY. ‘Amount Received 2200 Balance Ss) Discount ee{ t t SAI MEDICAL 9° irri: MH-T23-198606 CHEMIST & DRUGIST GSTIN: 27ACHPD1265H12U 3, Near Marathi School, Phoolpada Road, Virar (E) - 401 303, Mob. : 9096350465, 9011422038, ee as a eG Address a we SaaS SY, Dr'sName 1270 ne pate: 41 81 2% Qty. DESCRIPTION Momrecuere Batch No. | Exp. Dt. pede é a a bp [Eso real 34 Ts | shea etacctan erage om. weet, E& rorat| 32) oT Any over charged through over sight will be refunded. Noe ! SAI MEDICAL = °™ testes: CHEMIST & DRUGIST gsm. rgcnporasnzd 3, Near Marathi School, Phoolpada Road, Virar (E) -401 303, Mob. : 9096350465, 9011422038 PT Name__DUteir No. Ae Ce a 838 Dr'sName [220 QNYOT Date 1 AAR: Qty. DESCRIPTION Mansfacturers! Batch No. | Exp. Dt. ee ae: WAB ap poabenk perl _ nea wPA|TPRIT 1a [Go shweteincaga a. yaaa. pon 29% 60 \ Any over charged through over sight will be refunded. @ Cagis Ga SS ara ||} Mamta Medical & General Stores + ‘Goode ones sald willbe not takon back Snes your Soctor betore using these medicines For Mamta Medica (No. 7 F20-MH-PL1-502031, F21-MH-PL1-502032 E80e i Chemist & Druggist ‘CASH MEMO ‘Shop No 6, Chistiva Manz, Bazarward, Ne. Vira Raway Footover Bridge, Vira (East) -404 305 Patent PTE DOU, moe Che 8 Ae NLLASoRARA MEST Doctor DR FAFESH AYYeR Dae: sores |S Add. SHREE BALATI HIEPITAL é a: i aaa Ne Renee 2a TM OHH NO ea | 2 1X 2061 TUB PETROGYL POINT eB ORES 0125 152.85 |F ba 2X20 AP BESET 2G INT CIPLA 8620066 08/23 29.06 |Z 5 1X AN- PRT LLY SET POLYM aacmaz 01/23 148.00 |* : 4X oon BOT ITA. z Wis. noice 07252. le = 1X 10S PRT VENLON 22 80 Cee 1 X SOM. BOT AL SOOHL TV Fee uo 107s ee |e owes vais [F aata sect at fear S are are | TOTAL 7ai-i5 : |} Mamta Medical & General Stores + 3 Chemist & Druggist ‘CASH MEMO. = | snopno6, chistiva Mons Bazarward, Ne. Vira Raliway FootoverBridgo, Vier (Eas) 404 305 3 Patent PETER DCUNHA, Involes = pats 367 L | cose mest aren ee: arr |e po [ae ie = jm os oo ra: i 1X 1561 TUB DREZ ONT SD bas 525 119.00 | P 10 X1eB STR CIPLOK TaH Tae CIMA semi 1225 © 96.39 |? 5 | isxwe sRamate fu zwome tos ie |e S| is xwe sm zoe we WX TZ CBA 105.00 F055 £505.59 [| carat staee at fart & are are | TOTAL: 505.37 eect potrBactr nte ung ines medicines a ATNo, + F20-MH-PLI-502031, F21-MH-PL1-502032 a £808, 7 Teas RInr BRIA BATS &250)2571685 Mob.: 7709073579 + start giitaca + ft-figiaer faredin, argre arg, farae (qa) - ¥0R 204. QE. TER tate 2// Zio eae 62 IL Gt hd OE at ee RO xxii ee 4 P Ayyar Mass. Ms. OM eM e attnest Sa Na 88 ‘Tel: (025012521685 Mob.: 7709073679 + ataenet gileaca + Fagan factin, arg arg, fart (qa) - vo g B04. PETER tote LLY, DEMS. Ayyar wsss.ss eee FAIS. FACRS\. aa No. T8‘Tel: (0250)2521685 Mob.: 7709073579 + st aeust aiftuca + ai-firgiame faregin, are a7, fart (qa) - vok Fok. fete _L/ L/os PEI ae : Eos TE LO Tel: (0280)2521685 Mob.: 7708073579 + st aeuet giftaca + ah-frgtam faregin, ange ag, ferare (Ga) - wok 204. fee SIZE 4 PETE —_—— Leelee: 2 ae Cz pn LG, cer er JrTob: Lincon | QT ) AY few fooel slaps carne are Sr ole eer qeoel qob- Ciplex SPT 1 Aye dood Tah 4 §-] st phe goood.v Dr. Padmashree V. Jadhav — M.D; D.A. (Mumbai) Reg. No. - 61462 CONSULTING ANAESTHESIOLOGIST No 1313 Date: 317] 2.3 RECEIVED with thanks from_C eter _0 curnhre. the sum of Rupess Ture _-tRro wand a by chedue / cash in full / part payment of our Bill No,_13'3____ated_317]2? _/ ave of. Anaesthesia, tages toe Seen & 3000 — ) odbhe The rect vad subject to Reason of chaque SignaturePatient Details PatientNo CGMH23018920 Patient Name Mr Peter B Dcunha Age / Sex 62 Years / Male Ref By. Dr. Joel Tuscano Company S.No | Service Code Service Name “1. MRIMo000048, MR FISTULOGRAM 2. MRio900035 MRI CONTRAST S.No Payment Mode | Number | Date | Bank 1 Credit CardiDebit OXX Card 0K OK ee69 ‘Amount in Words: RUPEES Eight Thousand Only. Remarks Beng, Snr POs ist. Paha 401201 CARDINAL GR silicide RIAL HOSPITAL TRUST & Tet: 79507624247050772424/7950622426 7350832424 Emad pmhoepite@yahoecam Website wow saréalacishosptalcen GSTIN 27AAAACO4SAB1ZA Patient Copy Request No cGoP230076449 Request Date 26-07-2023 12:07:55 ill No CGOBL230078478 Bill Date 26-07-2023 12:07:55 Patient Category Senior Citizen ‘Token No. | Rate(Rs) | Qty Amount (Rs) 0 8235.00 1.00 6500.00 © 1500.00 1.00 1500.00 Gross Amount (Re) 9735.00 “Amount Concession Amount 1736.00 00000 —__Net Payable By Patient 1000.00 Net Received From Patient 8000.00 MRI REPORT DISPATCH Cet Al Pending Investigation Reports | Xray Fs From Department ihn 1 Week From ischarge Dat. No Refund on Sundays | Pubic Hodays Repos wil be sued only apis he Receipt.Tel. : (0250) 2521685 A arash etferet 777° ‘ft-fratarre Pregl, are arg, fiers (Ga) - wot 30%. priua spy ose is General & Colorectal Surgeon 8 Laparoscopy Surgeon Dr. Shriram Ayyar MBBS, MS. (0b. Gx) Reg. No. 2005 03 1500 Obétetrician & Gynaecologiat Reg. No. 72661 Laparoscopy & Vaginal Surgeon Rx Pek ty Deunhe pate: 21 [4/2009 Spival Needle Ne 2s —() Cutesept Soln werd — @Q »Metelogy-P Cream 259m diy ocaine Oly 270 Jonac Supporitory =o) IV AF 100 me LTV~ Meteo joomt Dd Tj- Plarcef dqrms 4) Taj Creuta 4 shied ee Gai ~ Emeset ary -@ eu floc Qrny? -@ Fj: Ail b 6) - 2 Que RL fy ter Q— ' qT F 2. M phen Ne 22- y iplrm THM 40). vflom Tp "pede srry =DTel.: (0250) 252 1685, 252 2001 SHREE BALAJI HOSPITAL B, Mirzanagar Building, Bazar Ward, Near Railway Station, Virar (East), 401 305. ait-fergtare facia, arg arg, Faraz (ah) - ¥oR Bot. Bill No. 2657 122 Ft 166FF paty, 2/28/24 smtishi 22724 léwrruyw Derne — oe DESCRIPTION AN OUNT. + | Consultation cota | 2 | Bed Charges (R8...aea jece ee 3 | Daily follow-up Check-up (Rs. loeb, 4 | Op jon Charges Nek cia eae 19ovoK ec 8 | Operation Theatre Charges eae 6 | Anaesthetist’s Charges. 77° /> 7 | Assisant’s Charges 8 | Delivery Charges 9 | Episiotomy/ Forceps Charges means 10[DressingCharges neers sBote “4 [injection giving Charges wea [12] 1V.8 LV. Giving Charges eae 13| Medicine's Charges stam 14|OtherCharges ms TOTALS 7 AE Reed. Amount | 77 2724 ¢ Bal. Amount] — Diagnosie 7 72275 _ 7) 7 Date of Admit = 7 7/2 3 Date of Discharge 2 //2=-/2 9 Date of Operation 27) 3/22