For s Hospitals Limited

154/9, Bannergha a Road.Opp IIM-B, Bangalore - 560076Tel +91 80-6621 4444, 2254 4444Fax
+91 80-6621 4242care.bng@for shealthcare.comCIN No U93000DL2009PLC222166

OUT PATIENT BILL

--------------------------------------------------------------------------------------------------------------------------------------
-----------------------UHID : WHBG.0000887356 Bill Date : 19-Aug-
2022 03:26 PMPa ent Name : Mrs. SAKSHI AGGARWAL Age : 32 Year(s) Bill No. :
CS35645395Sex : Female Bill Type : Cash BillDoctor Name : Dr. Athira RamaKrishnan

Sl. No.ServicesQty./TypeAmount (Rs.)

1.Comprehensive Preven ve Health Checkup112000.00

Total Amount

: 12000.00

Net Amount

: 12000.00-----------------------------------------------------------------------------------------------------------------------
-------------------------------------- Amount in words :

Rupees Twelve Thousand Only

Received with thanks from

Mrs. SAKSHI AGGARWALPayment Mode(s)

CC for Rs. 12000.00 (CCno. 4007, Card Name : VISA CARD)Cashier (MOHAMMED SHABEEB)--------------
--------------------------------------------------------------------------------------------------------------------------------------
---------

Reports needs to be collected between 10 A.M. to 6:30 P.M. within 15 days of the due
date. Please Note this consult is valid for One follow up visit within Five days (Except Psychiatry &
Psychology)

--------------------------------------------------------------------------------------------------------------------------------------
-----------------------

Regd. Office :

For s Escorts Heart Ins tute and Research Centre, Okhla Road, New Delhi - 110 025
(India)www.for shealthcare.com | www.for sbangalore.co