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    Mr. Sourabh Shriwatav, a 42-year-old male, paid Rs. 1450 in cash for medical tests on November 20th, 2023 at 4:18 PM upon referral by Dr. C G Dogne. The tests included a complete blood count, dengue profile, and complete urine analysis. After paying the total amount due of Rs. 1450, Mr. Shriwatav's payment was recorded.

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    Mr. Sourabh Shriwatav, a 42-year-old male, paid Rs. 1450 in cash for medical tests on November 20th, 2023 at 4:18 PM upon referral by Dr. C G Dogne. The tests included a complete blood count, dengue profile, and complete urine analysis. After paying the total amount due of Rs. 1450, Mr. Shriwatav's payment was recorded.

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    8 views1 page

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    Uploaded by

    sachinojha774
    Mr. Sourabh Shriwatav, a 42-year-old male, paid Rs. 1450 in cash for medical tests on November 20th, 2023 at 4:18 PM upon referral by Dr. C G Dogne. The tests included a complete blood count, dengue profile, and complete urine analysis. After paying the total amount due of Rs. 1450, Mr. Shriwatav's payment was recorded.

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    RECEIPT

    Receipt No. : D - 20174 Name : Mr. SOURABH SHRIWATAV (ID: 16424) Sex / Age : Male / 42 years

    Payment Mode : CASH Referral : Dr. C G DOGNE Date & Time : 20/11/23, 04:18 PM

    Sr. Test Name Test Price

    1 Complete Blood Count (CBC) 300.00

    2 Dengue Profile (Antibody & NS1 Antigen) 1000.00

    3 Complete Urine Analysis (CUE) 150.00

    Payable Amount (in words) : One Thousand Four Hundred Fifty only Total : 1450.00

    Payable Amount : 1450.00

    Total Paid : 1450.00

    Cashier's Signature

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