PAYMENT RECEIPT

Patient UID : MUM240100026751

: Receipt No : 2024011261
Patient's Name : MRS. KHAN SHAHBAZ Visit ID : 29953
Age / Gender : 31-Y / M Centre Name : Ubercare Malik
Ref. Dr. / Hospital : RAJU G. KANAK Date : 29 Jan 2024
Sr. Modality Study Qty. Rate Gross Amt
1 . PATHOLOGY KIDNEY FUNCTION TEST (KFT) 1 300 300
2 . PATHOLOGY LIPID PROFILE 1 300 300
3 . PATHOLOGY THYROID PROFILE 1 250 250

Total Bill Amount : 850

Net Amount : 850
Paid Amt : 850
Amount in Words : Rupees Eight Hundred and Fifty Only
Payment Mode : Google Pay

*** Please Collect reports within 7 days ***

(Customer Signature) MUZAMMIL INAMDAR

(Front Office Executive)
Kalsekar Hospital, Annexure Building,Near Bharat Gear "C" wing, Malik Residency,Plot No. D - 20,Tanwar Nagar,
Company , Dawla Village,Kausa, Thane - 400612 Kausa,Mumb Thane - 400612
M: 9168298472 - 9168298573 M: 7400068789

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