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Bangalore - 560076 (India)
Tel.: +(91)-80-26304050 / 26304051 Fax: +(91)-80-41463151
, anduranga Nagar,

INPATIENT BILL
PATIENTDETAILS IP No. :97101IDNo. :0000246611 Bill No. : ICR33504
Bill Dt./Time :13-Jan-201310:06AM Admission Dt./Time: 10-Jan-2014 7:22 AM Discahrge Dt./Time: 13-Jan-201410:06AM

Saravana kumarV

A2 Nagesan nagar Vadalur Cuddaloretaluk TamilNadu

·------------------------------------- DETAILS ---------.,---,----------

·-- £- --------------------------- A_mou_n_1_1R_s._1 _
!!!.1!.

ROOM RENT 4,000.00

PHARMACY 2,765.54
MEDICAL EQUIPMENT 1,000.00
CONSULTATIONS 2,400.00
CONSUMABLES 2,118.00
INVESTIGATIONS 2,860.00

Bill Amount 15,143.54

In Words :
Fifteen Thousand Hundred Forty Three Rupees and Fifty Four Paise.

Refundable Deposit As On 13-Jan-201410:05 AM Rs.5000

This isa computer generated statement and requires no signature .

This Receipt isvalid for an employer or insurer, who iscontractually obligated to reimburse the medical expenses covered by
MediSave and/or MediShield.

For billing and general enquiries, please mail: customercare_bangalore@apollohospita ls.rom

(0 Apollo Hospitals, Bangalore 2013, All Rights reserved