Tirupati Software InfoTech Pvt. Ltd.

#244-A, Ravindra Nagar-A, Airport Road, Jagatpura, Jaipur-302017 (Raj.) India

9929202855/ +919462702855 , Email :- info@tirupati-international.in

IPD Final Bill Details

IPD No. 149 Bill No. 000274
Patient Name Miss. neha/ / trivedi D/o :- kishan trivedi Bill Date 10-02-2024
Age/Gender 27 / Female UHID TS2023RG682
Address Paota Road, Jodhpur Bed/Room SEMI DELUXE
Contact No. 9364827831
Consultant Ramendra Shraff Sponsor Cash IPD
D.O.A. 20-11-2023 10:44 AM D.O.D. 10-02-2024 18:10 PM
Discharge 5-Reffered to Psychiatric
Reason

Particulars of Services/Items
S No. Charges Nos Amount Dis.Amt Net.Amt.₹
Provided
1. IPD CHARGE
20-11-2023 B.M.W(SEMI DELUXE) 500.00 22 11000 0.00 ₹ 11,000.00
COUNSULTING
20-11-2023 1,500.00 22 33000 0.00 ₹ 33,000.00
CHARGES(SEMI DELUXE)
20-11-2023 RMO CHARGE(SEMI DELUXE) 800.00 22 17600 0.00 ₹ 17,600.00
NURSING CHARGE(SEMI
20-11-2023 550.00 11 6050 0.00 ₹ 12,100.00
DELUXE)
ROOM CHARGE(SEMI
20-11-2023 3,400.00 11 37400 0.00 ₹ 74,800.00
DELUXE)
₹
Total
148,500.00

2. Lab-Test
28-11-2023 CBC/ Complete Hemogram 200.00 1 200.00 0.00 200.00
28-11-2023 LFT-Liver Function Test 750.00 1 750.00 0.00 750.00
Total ₹ 950

3. Doctor Fee
28-11-2023 Consulttion Fee 950.00 3 2,850.00 0.00 2,850.00
₹
Total
2850.0000

4. Hospital Charges
28-11-2023 O.T. CHARGE 8,500.00 1 8,500.00 0.00 8,500.00
28-11-2023 VENTILATOR 5,000.00 1 5,000.00 0.00 5,000.00
Total ₹ 13500

5. X-Ray
X-RAY SHOULDER (AP/LAT
28-11-2023 600.00 1 600.00 0.00 600.00
VIEW)
Total ₹ 600.0000

6. USG
28-11-2023 USG- SONOGRAPHY 850.00 1 850.00 0.00 850.00
Total ₹ 850.00
 Card
Receipt No. Receipt Dt. Payment Amt Disc. Amt Net Amt. Cash Chq. Amt Due Pending
Amt.

ADV-208 20-11-2023 0.000 0.00 0.00 0.00

ADV-209 20-11-2023 0.000 0.00 0.00 0.00

Multi Payment Due Amount : 0.00

Payment Details :

Cash 0 Total Bill Amount( ₹ ) ₹ 167,250.00

Cheque 0 Discount (In Service ₹ ) ₹ 915.000
Card 0 Advance & Received Amount ( ₹ ) ₹ 0.00
TPA 0.00 Payable ( ₹ ) ₹ 166,335.00
Refund if any 0 Net Amount( ₹ ) ₹ 166,335.00

Amount In Words:- One Lakh Sixty-Six Thousand Three Hundred and Thirty-Five.Only.

Hospital Radiology Pharmacy

₹ 164,850.00 Lab Bill: ₹ 950.00 ₹ 1,450.00 ₹ 0.00
Bill: Bill: Bill:
Hospital Lab Radiology Pharmacy
₹ 0.00 ₹ 0.00 ₹ 0.00 ₹ 0.00
Advance: Advance: Advance: Advance:
Total Total Total
Total Lab
Hospital ₹ 164,850.00 ₹ 950.00 Radiology ₹ 1,450.00 Pharmacy ₹ 0.00
Pending:
Pending: Pending: Pending:
Hospital Lab Radiology Pharmacy
₹ 193,550.000 ₹ 0.00 0.00 ₹ ₹ 0.00
CashBill: CashBill: CashBill: CashBill:
Lab
Hospital Radiology Pharmacy
₹ 0.00 Refund ₹ 0.00 ₹ 0.00 ₹ 0.00
Refund Bill: Refund Bill: Refund Bill:
Bill:

Bill Prepared By YOGESH LOHAR

Account Dept. Signature