Nova IVF Fertility East Pvt. Ltd.

Gama - Kolkata
3B, UTTAM KUMAR SARANI (ALBERT ROAD) KOLKATA - 700107
WEST BENGAL, INDIA
Tel : 3371092300 , GSTIN: 19AAHCP9483A1Z4

PATIENT BILL OF SUPPLY

Patient MRN : KKR08531 Bill No. : GMA/IP/23/3664
Patient Name : Lalremruati Chhangte Bill Date : 03/11/2023
Age / Gender : 42 Year(s)/Female
Surgeon : Dr. Rohit Gutgutia
Patient Address : T 6/A Tuivamit
Service Name SAC Qty Rate (Rs.) Amount (Rs.)
Additional Cryotop 999312 1.00 4000.00 4000.00
Embryo Freezing - 1 Year 999312 1.00 20000.00 20000.00
Gross Total (Rs.): 24,000.00
Total Bill Amt (Rs.): 24,000.00
Paid Amt (Rs.): 24,000.00

Twenty Four Thousand Rupees Only

Remarks : Signature :
Printed On: 20/11/2023 12:34 PM
Prep By: Somnath Mondal

Whether tax payable under reverse charge – NO