Dr. Basanth Kumar.

S MB8s, MD (Modisin)

Consultant Physiclan: Kompegowda

Inetitute ofModical Sciences
KMC No. 66499

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9886469161
226, 10 Main Road, 1st Block HRBR Layout Kalyan Nagar Bangalore 560043 I Mobile
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 SPECIALIST HOSPITAL
216, 7th Main, 80 Feet Road, 1at Block, HRBR Layout,
Kalyanagar 560043,Bengaluru,Karnataka,Indla
PH Hospital: 08042122222, Laboratory:080 69244466 www.specialisthospital.in
Hospital Reg.No: 47/2013-2014, GSTIN:29AASCS6541H3ZO
SH-MRN-308006 SH22-0PB-211777
Mrs. Suvarna M 2023-03-25 07:40:01
213 Prestige Gulmohar 78Y FEMALE
KALKERE, Bengaluru 560043 9620215109
Ref. By: Cmo

OP Receipt

Service Description Qty Rate Total

1 FASTING BLOOD SUGAR (FBS) 328555 1 70.00 70.00

2 POST PRANDIAL BLOOD GLUcOSE (PPBS) 328556 1 70.00 70.00
3 HBA1C 328557 700.00 700.00
Discount 84.00 Total Amount 840.00
Sub Total 756.00 Roundoff O.00
Grand Total 840.00
D Amount Pald 756.00

1 of 1
For Lab Test queries-Call 080-69244466.Covid Sample collection Time:8 amto 4pm
Printed by Sukanya /2023-03-25/07:40:03
REF#369198
Received By: Sukanya
 SANTHOSH CLINIC
# 973, 1st Block, 3rd Cross HRBR Layout, Banaswadi,
Bangalore- 560 043. Mob: 98864 69161

No. 024 Date h

Received with thanks from daos*ess**

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a sum of Rs: A.

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Dr. Basanth Kumar. S MB.S., M.D. (Medicine)
Consultant Physician
Kempegowda Institute of Medical College &Hospital
 GST INVOICE

PR NO.44/3, SITE
GSTIN: 29BFWPG3652N1ZL
Patient: SUVARNA
MAMTA PHARMA
NO.23, GROUND FLOOR HORAMAVU MAIN ROAD, NEAR
,
BBMP OFFICE, BENGALURU-560043
Mobile No: 7676582439
DL.No: 20-KA-B51-199750,21-KA-B51-199751
Bill No: S45170

Time 08:26 PM Date 26-03-23

Doctor: BASANTH
Batch Exp MRP GST % Amount
S.No Item Name HSN Code Qty Mfg.
DIABETROL SR TAB 30043190 170 ABBO AJJOO03 12/24 8.329 12 141593
B5IAV237 10/24 3.859 12 578 85
TELMIKIND 40MG TAB 30049079 150 MAN
ECOSPRIN AV 75MG TAB TF23B060 07/24 4.043 12 727.74
3 30049062 180 UVL
SHELCAL XT TAB 30045039 60 TORR GBRC015E 10/24 27.637 12 165822

NOTE
TAXTAXABLE CGST TAX AMTsGST TAX AMT Total Qty 560 Sub Total : 4380.74

Total Items 4
0% 0.00 0.0% 0.00 0.0% 0.00
Tax Amt ,469.34
5% 0.00 2.5% 0.00 2.5%| 0.00
12% 3910.99 6.0% 234.67 6.0% 234.67
18% 0.00 9.0% 0.00 9.0%| 0.00 Total: 4380.00
Sigpfure
Registéredehagacist
 SPECIALIST HEALTH SYSTEMS Pvt. Ltd. Patient ID : 308006
# 216, 7th Main, 80 Feet Road, 1st Block
Name : Mrs. SUVARNA M
HRBR Layout,
Kalyanagar, Bengaluru Age/Gender : 78Y/F
Karnataka, India-560043 Date/Time : 25-03-2023/07:38
PH : Hospital: 08042122222, Laboratory: 080 69244466 www.specialisthospital.in
Referred By : CMO

INVESTIGATION RESULT REFERENCE RANGE

BIOCHEMISTRY
LRN-328555
FASTING BLOOD SUGAR (FBS)
Fasting Blood Sugar 118 mg/dL 65 - 110 mg/dL

Sample Collection 25 Mar 2023 / 07:41 Received at 25 Mar 2023 / 08:10

Result Approval 25 Mar 2023 / 10:37

LRN-328556
POST PRANDIAL BLOOD GLUCOSE
Post Prandial Blood Glucose 153 mg/dL 92 - 140 mg/dL

Sample Collection 25 Mar 2023 / 11:00 Received at 25 Mar 2023 / 11:39

Result Approval 25 Mar 2023 / 13:20

LRN-328557
HBA1C
Glycosylated Haemoglobin 6.3 % NGSP/DCCT
Method:HPLC ( 4.0 - 6.0 )
6 - 6.5 % : Excellent
6.5 - 7.5 % : Good
7.5 - 8.0 % : Fair
> 8.0 % : Poor
MBG (Mean Blood Glucose) 134 mg/dl
Method:Calculated

Sample Collection 25 Mar 2023 / 07:41 Received at 25 Mar 2023 / 08:10

Result Approval 25 Mar 2023 / 10:37

------ End of Report -----

T Kavitha Dr Kathleen
Typist Pathologist

This is an Electronically Generated Report. This report is based on the specimen/s received. The report may need to be correlated clinically as
laboratory investigations are dependent on multiple variables. These results should not be reproduced in part
1 of 1 REF# 369199 2023-03-25 / 13:52:47

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