Professional Documents
Culture Documents
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Nam~ ...f.c0tlt.~.~······;······:······ Ag~ .?.~ Sex~
.Wai-d ____ f -~ -~----- Bed No ___ --·---·--···· O.P. D. No~ ..t-~
·Brief Clinica~ Notes & Prov. •piag... f.~.~ .. ...
P~ ·to be radiographed.... ~ --........................ .
M.I. (For medioeg, t _c~~s only)- .,.
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F.or/ Paid .......................... :;.... Signature .of M.O. I/ C
Sanction of the Superintend~nt.
REPORT: 7l . . ' , •.
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I . .,1t~ospital Uttarkashi,U
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District Hospital Uttarkashi, D1stn '
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Y-o~~~rtme~t: General OPD Registrafi
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: N-ame.:· PAIWATI - -~ · ' ·Father/Hu and N'ame: MR ..
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,' :;!r-e,; _20,.Ye_
a r(,s) .;, • ., Gender : eroale \
l~:ategory,; APC-::-.. 1
Date...: 03'" 4/2_0·.·L..ij
Date History/Complaints :
Examination:
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GST INVO ICE
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Patient Name: PARWA1 \
Patient Phone: 0 CASH Date 08/04/2023
SUBTOTAL 76.41
Discount 20 % 15.28
All Disputes Subject To Rishikesh Jurisdiction Only. I SGST6 % 3 .28
For NIRMAL ASH_R AM HOSPITAL CGST6 % 3 .28
Goods Can Be Returned Under 15 Days Only.
Roundoff 0.14
Without Bill Goods Cannot Be Returned.
Authorised Signatory
GST NO. :
05
AAA~~~~L
1--D_L_N_o_._:u_A_-o_E_H_-_
11_1_48_8_&_u_ A
ASHRA~!!A?u~~~s!!~. MEDICAL STORE
_-_o_E_
H-_1_11_4_8_9 _ _3_D_E_H_R_A_o_u _N_u_n_ A
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Phone : 0135-2430142,2432215
_A_K_H_A_N_D_-2_4_9_20_1_ _ _ _ _ _ _ __ _ _ _ __ _,
Party Name :
Patient Name : parwati
Patient Phone:
parwati
1 Dr Name :
CASH
I Invoice No.
Date
A003927
06/04/2023 1
SNo. \ PRODUCT NAME 1 Pack
I HSN BATCH EXP. QTY, M.R.P. Amount
I I DIS¾ /
1 \ CALPOL-650 TAB 1'15TAB
2 PANTDOT-L CAP 1'10CAP
1 1'15T
1 1·1oc
3004
3004
i EA101 I 11/24
GC3026B I 11/24
I 5
3
I
34.07
I
270.00 '
s.oo
10.00
I
I
11.36
81 .00
3 ULTRACET-SEMI TAB 1'15TAB. • 1' 15T 3004 J12010 I 11/24 I 9 146.00 5.00 87.60
4 TUDOR-FORTE TAB 1'10TAB I 1*10T 3004 i LGL 11/15 I 4/24 I 6
I
360.00 7.oo I 216.00
I
5 LIZOKEF-600 TAB 1'10TAB 1*10T 1901 KLE2208B 6/25 6 356.00 5.00 213.60
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I ' II
I II
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SUB TOTAL 609.56
Discount 38.85
All Disputes Subject To Rishikesh Jurisdiction Only. SGST6% 30.58
Foe NIRMAL ASHRAM H~S~ ~L 'STORE : CGST6% 30.58
Goods Can Be Returned Under 15 Days Only.
Roundoff 0.29
Without Bi// Goods Cannot Be Returned.
Aµthorised'Signatory
... J
- - - - - r 1
J .,
1l-
---- - -- - - - -
j Rs. Five Hundred Seventy One Only GRAND TOTAL 571 .00
GST INVOICE
8 8
1-g-~_:_~o_:u_~_~;-~_/_~_~_!t _~s-M:
_~z_;_D_~---~-'_48_~_R
_ :_DE_~_RM_/_
! _t_K~-~_;_,:_;_;_t_~_t_~2-~_92_0E
_1-D------,Ic_ Ph_~_ne_ _oT
-13_?_24_~_0_14_2._24_3_22_1_5 _ - ; /
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Party Name:
Patient Name : MS PARWATI
MS PARWATI Dr Name :
I Invoice No. A002623
I Date 04/04/2023
Patient Phone: CASH
r - - - -- - - - - - , - - - - - - - - - - - - , - - - - - - - - - - . - - - - - . - - - - - 1
SNo. , PRODUCT NAME . Pack I HSN
I BATCH EXP.
1
QTY : M.R.P.
i D1S% i' Amount
1 , LIZOKEF-600TAB1*10TAB 1•10T I 1901
I KLE2208B 6/25 ' 4 356.00 5.oo I 142.40
I I
2 I TUDOR-FORTETAB1*10TAB 1•10T 3004 LGL11/15 4/24 6 360.00 7 00 ' 216.00
I
I
1
3 ULTRACET-SEMITAB1 . 15TAB. 1•15T I 3004 J12010 11/24 6 146.00 5.00 , 58.40
I I
4 [ PANTDOT-L CAP 1*10CAP 1·1oc I 3004 GC3026B 11/24 2 270.00 10.00 54 .00
I CALPOL-650 TAB 1*1 5TAB , 1•15T I 3004 ·'
5 EA101 11/24
I 4
I
34 .07 1 5.00 I 9.09
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SUB TOTAL 479.89
Discount 31 .01
' SGST 6 % 24 .04
All Disputes Subject To Rishikesh Jurisdiction Only.
Goods Can Be Returned Under 15 Days Only. Foe NIRMAL ASHRAM HOSPITA~ ~~ E I
CGST 6 % 24.04
Roundoff 0 .12
Without Bill Goods Cannot Be Returned. I
I
Auttiorised Signatory I
I
-
Rs. Four Hundred Forty Nine Only I GRAND TOTAL 449 .00
GST INVOICE
SNo. \ PRODUCT NAME Pack HSN BATCH EXP. I QTY. M.R.P. DIS% Amount
1 1 TRIMMER RAZOR 1*1 PCS
2
3
I EXAMINATION GLOVES 1*1PCS
CX-S 1.5 INJ 1*1 INJ
1"1PC
· 1*1PC
OTHE
4015
G2212100
SH220855
11/27
7/25
2
6
37.00
8.00
10.00
5.00
74.00
48.00
1*11N 3004 822322A 7/24 2 275.00 10.00 I 550.00
4 \ PANTDOT-E INJ 1*1VIAL 1*1VI 3004' SDG-338 10/24 2 175.00 10.00 350.00
5 I CANNULA-BO 20NO . 1*PCS 1*PCS 9018 2334023 11/27 283.50 I 70.00 I 283.50
6 CANNULA FIXER TAPE 1*1 PCS 1*1PC 3004 1S006322 8/27 1 75.00 1 53.00 I 75.00
7 i DISPO-VAN 10ML 1*1PAK
8
9
I DISPO-VAN 5ML 1"1PAK
DISPO. NEEDLE 18X3i 2 1*1APK
1*1PA
1"1PA
1 1*1AP
9018
9018
250103JY
245055NC
11/27
10/27
2
2
10.00 I
8.50
30.00
30.00
20.00
17.00
9018 40244P 8/27 2 2.50 5.00 5.00
II I
I
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SUB TOTAL 1422.50
Discount 349.35
'
SGST6 % 57 .50
All Disputes Subject To Rishikesh Jurisdiction Only.
Goods Can Be Returned Under 15 Days Only.
For NIRMAL ASHRAM HOSP! I&RE CGST6%
Roundoff
57 .50
0 .15
Without Bill Goods Cannot Be Returned. ,, r ,. .;\1iJ.,
\.. \
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Authorised Signatory
SU B\T OT AL
•. ,,.\ Discoun\
All D,spules Subject To Rishikesh Jurisdiction Only. • SGST
Goods Can Be Returned Under 15 Days Only. Fo, Nli1MAL ASH RAM HOSl'ITAL MEDICAL ST ORE ' '\
Without Bi/I Goods Cannot Be Returned.
I
Rs . One Thous and Two Hundred Six ty Three Onl y
Authori sed Signat o ~
_..,,• .
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Phone : 0135-2430142,2432215
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Party Name : CASH Dr Name : Invoice No. A011085
Patient Name : Date
CASH 17/04/2023
Patient Phone:
SNo. PRODUCT NAME Pack HSN BATCH EXP. QTY M.R.P. / DIS% Amount
1 ARM SILING POUCH-FT 1*1PCS 1*1PC 9021 AS02 1 30.00 400.00
400.00 1
I
I
I SUB TOTAL
\
400.00
SchemeNolume Discount 18.00
All Disputes Subject To Rishikesh Jurisdiction Only. Discount 30 % 114.60
Goods Can Be Returned Under 15 Days Only. For NIRMAL ASHRAM HOSPITAL MEDICAL STORE SGST2 .5 % 6.37
Without Bill Goods Cannot Be Returned. CGST2.5% 6 .37
Roundoff 0.40
Authorised S ignatory
I Rs. Two Hundred Sixty Seven Only
GRAND TOTAL 267 .00
GST INVOICE
I
1
1 I
33.50
176.00
5.00
75.00
33.50
176.00
I
2230502 12/25 I 1 56.42 20.00
7 I NS-100ML IN 1*100ML
8 I LORl-2ML(DIAZEPAM) 1*1AMP
1·100 3004 II 82011686 11/25 2 19.65 5.00
56.42
3004 I 39.30
11*1AM AND41002 9/23 I 1 14.00
9 / PENTAZOCINE \NJ 1 "1AMP I 5.00 14.00
1*1AM 3004 MHTl-003 1/24
10 r TRAMADOL-2ML \NJ 1*2ML ' 1 38.50 0.00 38.50
: 1*2ML OTHE 1 27762204 7/25 1
11 1 EMESET-2ML !NJ 1 '2ML 26.00 5.00 26.00
' 1*2ML 3004 S620075 8/25
12 1 DISPO-VAN 20ML 1*1PAK 1 14.53 5.00 14.53
1
13 0/SPO-VAN 10ML 1*1PAK
1*1PA I 9018 304201JG 12/27 I 2 25.00 10.00
1*1 PA 9018 50.00
250103JY 11/27 , 2 10.00
14 ! MAGNEX FORTE-1 .5 INJ 1 *1V/AL · 30.00 20.00
1*1VI 1901 2239146A 7/24
15 / H/NGLACT- 1NO HP23470 180 1*1 1 729.06 5.00 729.06
1*1 PC 9018 ·1 2300030 1/28
16 / H/LON 2-0 3336L 2-0 RIC 1*1 P 1 525.00 5.00 525.00
1*1PC 9018 S3622002 6/27 1
1- , "\~~\~J_\
170.00 5.00 I 170.00
Terms & Conditions
All Disputes Subject To Rishr~esh Jurisdiction Only. -,,q':\~ -_-, r. TOTAL C/F 2475 .12
r,1t~ mClr
Goods Can Be Returned Under 15 Days Only. ~-'' , ~·- J •·· r .•
w;1hout BUI Goods c'""" Be Rol"med For NI R MAL ASH R'li~ ',!·; STORE
I
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-1,:""J_,.'•' SUB TOTAL 3925.02
\ . ,··. ,. ·7' ,.,.. :. \..,. Discount 655.70
All Disputes Subject To Rishikesh Jurisdiction Only. r',.I.
SGST 173.30
Goods Can Be Returned Under 15 Days Only. For NIRMAL ASHRAM HO,SPI r\L ~E01CAL STORE CGST 173.30
\(_ I .
Without Bill Goods Cannot Be Returned. Roundoff 0.32
1
; i;-..i - Signatory
~{j)
Cipro
s_ Ryle's T e ;flo/i_- - - 0.), Metrogyl o
9_ Urobag ,e-:
p@)p(/!£}W- /;2
"\O _ Cord-cla ~:!~:one ~/"11
· -(/
v-/' c2--V_}¤; R(;)~
ffi
Baby Oil / . Prolene
S ~fra-tulle <::-- \...j() U
ABGEL _:) Vicryl
Op Site M e rsilk HtkJr>f'J.:::V) /1
'\4 .
Gly co- . V
'\5. Gypsona
Atropine \ (")
16.
17.
18_
Micropore
Bandage ~ - '\•
Romovac
A"".: ·
@ (!!JtiiY _
51 .
52.
Adrenaline
Efcarlin
U?- f - ~
r-/J,1nw --C. }.__.(v./J
19_ Corrugated drain 53. Skin Graft Blade '' //VV "l"> -
54.
-=--:c-
20. Dispo Van Aminophylline
21_ RI 55.
56.
Dopamine
v1J..O ~~f71CJ -
(j) ~'M2-
22-DNS Pentothal
23_ DXTRS l- -JI_ 57. Scoline
24. NS _ , / D,0
'M 58. Pavuulon
25. · Diazepam - l 59. Norcuron
G, }ovt<5 -- 1-j_ {!!)
@)
26. Fortwin - - \ 60 _ Ketmin
27. Synto 61 . f
(/(j)
Sensorcaine
28_ Methergin ° -, 1 62. Xylocanie .
29. Phenergan l11cJ / 63. Cotton
Y)d {!)
O
64. Metrogyf Oint
;~: ~~o~todin J
65. Betadine Oint
32. Botropase 66. Ortho
33. Revici 67 _ Catgut
68 .
C\~~11
NIRMAL ASHRAM HOSPITAL Estb.1990
. Mayakund Rishikesh (Dehradun) Uttarakhand
Phones.: 0135-2430942, 2439551; 2439552, 2439553, 2439554, Fax: (+135) 2430142
e-ntail : nah@nirmalhospitals.com
(A Unit of Nirma/ Ashram, Rlshlkesh)
~ nature of Cashier
, , ~ j~ma
\ ' ..MBBS, MS (Orthopaedics)
\ . · MEDICAL DIRECTOR .;
............... - -..
UIIMI
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:.... .........
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,,, .We not only check the· pulse but touch your heart·.
f'J· ·••
ecurity Deposited :Rs. 2C
.C \ ~ ~ 1 1
NIRMAL ASHRAM ...HO
Mayakund Rishikesh (Dehradun) Uttarakhand
Phones.: 0135-2430942, 2439551, 2439552, 2439553, 2439554, Fax: (+135}2430142
e-mail : nah@nirmalhospitals.com
(A Unit of Nirmal Ashram, Rlshlkesh) Pri nted Or,
. Receipt Thursday Apr, / 06 . 202J
:: ;1 /\Jo Particui cJ 1
Rate Unit servarn ;:
118 , lL C DI C -
•
180 180
nsH (Giu co~(' l,;1111 1,)fll)
-- 50 1 50
1
-~~l{Rrfe'II
NIRMAL ASHRAM HOSPITALEstb.1990
Mayakund Rishikesh (Dehradun) Uttarakhand lndi
Phones.: 0135-2430942, 2439551, 2439552, 2439553, 2439554, Fax: (+135) 2430142
e-mail -: nah@nlrmalhospitals.com !430
(A Unit of Nlrmal Ashram, Rlshlkesh) 1l1.c
Date : 7/4/2023
Receipt P ri
IPD: NAH/IPD/2023/181
: NAH/Receipt/23~24/232_
0
:eceipt No. / F
: NAH/2023/196970
UHID Age & Sex 30
Name
Ms. Ms. PARWATI Amount--
Particular - ---- 200() - OD :
Sr.No
security Deposited
1
· Signa] jf cashier it
- -- ,Dr; Aja
. I \ ··: Sharma ·
i -.:MBBS, MS (Ortbopaedic1)
..
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- - - - --- _, ____
UHID NAH/2023/196970 Date :11/4/2023
Bill No : Cash/ NAH/INVOICE/23-24/209
DOD : 11/ 4 I 2023
DOA : 7/ 4 I 2023
IPD NAH/IPD/2023/1811
- - - --- -- - - - -
W/o ROSHAN SAHU
30 IF ;
Patient Name : Ms. PARWATI
T-07,MANERI DAM COLONY
PtAddress:
UTTARKASHI
----------
- - - - - - -- - - --
Security Receipt No. : , NAH/Receipt/2_3-24/2320
Security Deposited :2000
~r
•'.' / ..
;/
10 Minor Dressing in OT
100 100
250
250
,I 11 Forearm AP/LAT X-Ray
0
0
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Bill Amount :Rs. 27220
Less Security Deposited :Rs. 2000
I
Balance-Rs. 25220
J
DL NO.: P.Name: PARWATI DEVI (0SAAJCS7141Q1ZS)
Sno Item Description Part No. Brand HSN Qty. M.R.P. Rate Dis% GS Amount
4 CORTEXSCREW03.5MM l.25MM PX
16MM(S.T.) TIT
MP003T-16 MEDPLUS 90211000 1 1000.00 500.00 0.00 5%
soo.,i
5 CORTEXSCREW03.5MM 1 . 25MM PX MP003T-18 MEDPLUS 90211000 4 1000 . 00 500.00 0.00 5% 2000.00
18MM(S. T.) TIT
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Bank Details: AXIS BANK LTD A/C No.922030039192600 SUB TOTAL 15600.00
/ IFSC Code:UTIB0003427 Branch: DOIWALA, DEHRADUN ( U.K) Less Discount 0.00
Value ZERO% 5% 12% 18% 28% Less Special Discount 0.00
Base Value 0.00 15600.00 0.00 0.00 0.00 ADD SGST 390.00
Discount 0.00 0.00 0.00 0.00 0.00 ADD CGST 390.00
Taxable 0.00 15660.60 0.00 0 . 00 1:1.00 I ADD/LESS 0.00 )
SGST + CGST 780.00 0.00 0.00 0 . 00 ADD/LESS R0UND OFF 0.00 /
TOTAL 0.00 16380.00 0.00 0.00 0.00 GRAND TOTAL 163so.oo I
Rupees Sixteen Thousand Three Hundred Eighty Only