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Mobile No :, . Email :minthospitals@gmail.

com
PAN NO:AAKCM6077A / TAN NO:CHEM17453C / CIN NO:U74999TN2016PTC112873

Patient Bill
Patient ID : 200900154 Address : OLD NO. 31 Admit Date : 29/09/2020 8:00PM
NWE NO. 13
Patient Name : Mr.M MOHIDEEN Dis.Date :
4TH AVENUE
Age/Sex : 81/Male BESENT NAGAR , BESANT Ward Type : SRAC
NAGAR,CHENNAI , 600090
Mobile / Phone No : 9566030463 / Ward No : 303
TAMIL NADU,INDIA
Consultant Name : SRIVATSA,MD IP Bill No : IP/146/2020-21

Payment Type : Cash

Patient ID : 200900154 Patient Name : Mr.M MOHIDEEN Admit Date : 29/09/2020

Date Service Amount


GENERAL
30/09/2020 PHARMACY CHARGES 176.00
Day Total 176.00
03/10/2020 PHARMACY CHARGES 12.70
Day Total 12.70

GENERAL Total : 188.70

WARD CHARGES
29/09/2020 BED CHARGES 3000.00
29/09/2020 DOCUMENTATION CHARGES 750.00
29/09/2020 COVID-DUTY DOCTOR FEES 3000.00
29/09/2020 COVID NURSING CHARGES 3000.00
29/09/2020 COVID HOUSE KEEPING CHARGES 1000.00
29/09/2020 DIET 1000.00
30/09/2020 BED CHARGES 3000.00
30/09/2020 COVID-DUTY DOCTOR FEES 3000.00
30/09/2020 COVID NURSING CHARGES 3000.00
30/09/2020 COVID HOUSE KEEPING CHARGES 1000.00
30/09/2020 DIET 1000.00
01/10/2020 BED CHARGES 3000.00
01/10/2020 COVID-DUTY DOCTOR FEES 3000.00
01/10/2020 COVID NURSING CHARGES 3000.00
01/10/2020 COVID HOUSE KEEPING CHARGES 1000.00
01/10/2020 DIET 1000.00
02/10/2020 BED CHARGES 3000.00
02/10/2020 COVID-DUTY DOCTOR FEES 3000.00
02/10/2020 COVID NURSING CHARGES 3000.00
02/10/2020 COVID HOUSE KEEPING CHARGES 1000.00
02/10/2020 DIET 1000.00
03/10/2020 BED CHARGES 3000.00
03/10/2020 COVID-DUTY DOCTOR FEES 3000.00
03/10/2020 COVID NURSING CHARGES 3000.00
03/10/2020 COVID HOUSE KEEPING CHARGES 1000.00
03/10/2020 DIET 1000.00
04/10/2020 BED CHARGES 3000.00
Patient ID : 200900154 Patient Name : Mr.M MOHIDEEN Admit Date : 29/09/2020

Date Service Amount

04/10/2020 COVID-DUTY DOCTOR FEES 3000.00


04/10/2020 COVID NURSING CHARGES 3000.00
04/10/2020 COVID HOUSE KEEPING CHARGES 1000.00
04/10/2020 DIET 1000.00

WARD CHARGES Total : 66750.00

SERVICES
29/09/2020 PPE 5000.00
30/09/2020 PPE 5000.00
01/10/2020 PPE 5000.00
02/10/2020 PPE 5000.00
03/10/2020 PPE 5000.00
04/10/2020 PPE 5000.00

SERVICES Total : 30000.00

TREATMENT CHARGES
29/09/2020 CBG 450.00
30/09/2020 CBG 450.00
01/10/2020 CBG 450.00
02/10/2020 CBG 450.00
03/10/2020 CBG 450.00
04/10/2020 CBG 450.00
04/10/2020 FUMICATION CHARGE 1000.00

TREATMENT CHARGES Total : 3700.00

LAB
30/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
30/09/2020 LIVER FUNCTION TEST ( LFT ) 750.00
30/09/2020 RENAL FUNCTION TEST ( RFT ) 400.00
30/09/2020 CRP (C.REACTIVE PROTEIN) 350.00
30/09/2020 I L6 4000.00
30/09/2020 LDH 400.00
30/09/2020 URINE COMPLETE 250.00
30/09/2020 D - DIMER 1750.00
Day Total 8400.00
01/10/2020 HBA1C 500.00
01/10/2020 URINE COMPLETE 250.00
Day Total 750.00
02/10/2020 LIVER FUNCTION TEST ( LFT ) 750.00
02/10/2020 D - DIMER 1750.00
Day Total 2500.00
03/10/2020 COVID 19 (PCR) 3000.00
Day Total 3000.00

LAB Total : 14650.00


Patient ID : 200900154 Patient Name : Mr.M MOHIDEEN Admit Date : 29/09/2020

Date Service Amount

IP CONSULTATION
29/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 9000.00
30/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 9000.00
01/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 9000.00
02/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 9000.00
03/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 9000.00
04/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 9000.00

IP CONSULTATION Total : 54000.00

PHARMACY
29/09/2020 PHARMACY CHARGES 5892.00
30/09/2020 PHARMACY CHARGES 14200.00
01/10/2020 PHARMACY CHARGES 7749.00
02/10/2020 PHARMACY CHARGES 10100.00
03/10/2020 PHARMACY CHARGES 1518.00
04/10/2020 PHARMACY CHARGES 12925.00

PHARMACY Total : 52384.00

Total : 221672.70

Discount : 0.00

Rounded Off : 0.30

Total : 221673.00
Amount to be Received : 146673.00
IP ADVANCES
30/09/2020 2020-21/493 25000.00 CARD
02/10/2020 2020-21/502 50000.00 CARD

IP ADVANCES Total : 75000.00

Bill Prepared by : SELVI

Bill Checked by :
Authorized Signatory

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