Date : 07/09/2023 Page 1 of 11

Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
REV. DATE: 1/08/2023 11000.00 0.00 11000.00
CHARGE CODE: 96 - Blood Bank 11000.00 0.00 11000.00
SERVICE CODE : 9600010 - PRBC Service Charges 0.00 0.00 0.00
307635 322504 30/07/2023 01/08/2023 Miss. DHIYAANA SIDDHARTH PAREKH 2581 30/07/2023 511228 Twin Sharing -1 -1200.00 0.00 -1200.00
307635 322504 30/07/2023 01/08/2023 Miss. DHIYAANA SIDDHARTH PAREKH 2581 30/07/2023 511260 Twin Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600013 - SDP Process Charges 11000.00 0.00 11000.00
307651 252460 31/07/2023 04/08/2023 Mrs. MANISHA LOHIYA 2590 01/08/2023 511323 Single Ac Room 1 11000.00 0.00 11000.00

REV. DATE: 2/08/2023 0.00 0.00 0.00

CHARGE CODE: 96 - Blood Bank 0.00 0.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 0.00 0.00 0.00
307607 322423 28/07/2023 07/08/2023 Male Baby Of MAYURI DOUNDE 2577 28/07/2023 511270 NICU -1 -4500.00 0.00 -4500.00
307607 322423 28/07/2023 07/08/2023 Male Baby Of MAYURI DOUNDE 2577 28/07/2023 0 NICU 1 4500.00 0.00 4500.00

REV. DATE: 3/08/2023 21000.00 0.00 21000.00

CHARGE CODE: 96 - Blood Bank 21000.00 0.00 21000.00
SERVICE CODE : 9600004 - FFP Process Charges 4200.00 0.00 4200.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2599 03/08/2023 511318 Single Ac Room 4 2800.00 0.00 2800.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2601 03/08/2023 511318 Single Ac Room 2 1400.00 0.00 1400.00
SERVICE CODE : 9600010 - PRBC Service Charges 16800.00 0.00 16800.00
307685 30124 02/08/2023 06/08/2023 Mrs. YESHA DHAKAN 2591 03/08/2023 511382 Single Ac Room 1 1200.00 0.00 1200.00
307674 33421 02/08/2023 11/08/2023 Mrs. KAVITA SHARMA 2604 03/08/2023 511494 Single Ac Room 1 1200.00 0.00 1200.00
307712 155263 03/08/2023 07/08/2023 Mrs. SANGEETA LODHA JAIN 2605 03/08/2023 511386 Twin Sharing 1 1200.00 0.00 1200.00
307678 252136 02/08/2023 04/08/2023 Miss. KHUSHI OMPRAKASH JANGID 2594 03/08/2023 511331 Single Ac Room 1 1200.00 0.00 1200.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2598 03/08/2023 511318 Single Ac Room 1 1200.00 0.00 1200.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2603 03/08/2023 511318 Single Ac Room 2 2400.00 0.00 2400.00
307690 321702 03/08/2023 04/08/2023 Mrs. NIDHI AGARWAL 2592 03/08/2023 511285 Single Ac Room -1 -1200.00 0.00 -1200.00
307690 321702 03/08/2023 04/08/2023 Mrs. NIDHI AGARWAL 2592 03/08/2023 511327 Single Ac Room 1 1200.00 0.00 1200.00
307690 321702 03/08/2023 04/08/2023 Mrs. NIDHI AGARWAL 2592 03/08/2023 511285 Single Ac Room 1 1200.00 0.00 1200.00
307683 321741 02/08/2023 07/08/2023 Mrs. LEONIE N D'SILVA 2593 03/08/2023 511387 Single Ac Room 1 1200.00 0.00 1200.00
307697 322272 03/08/2023 05/08/2023 Mrs. MADHU JAIN 2597 03/08/2023 511317 Single Ac Room 1 1200.00 0.00 1200.00
307623 322481 29/07/2023 08/08/2023 Mr. RAVI GANGARAM PAWAR 2600 03/08/2023 511437 Economy 1 1200.00 0.00 1200.00
307633 322500 30/07/2023 03/08/2023 Mrs. VASANTI RAMESH PATEL 2583 30/07/2023 511288 Triple Sharing -1 -1200.00 0.00 -1200.00
307633 322500 30/07/2023 03/08/2023 Mrs. VASANTI RAMESH PATEL 2583 30/07/2023 511289 Triple Sharing 1 1200.00 0.00 1200.00
307687 322660 02/08/2023 07/08/2023 Mrs. HAJRA BEGUM MOHAMMAD EBRAHIM 2595 03/08/2023 511407 Suite Marigold 1 1200.00 0.00 1200.00
307692 322665 03/08/2023 05/08/2023 Mrs. ZAINAB CHUNAWALA 2596 03/08/2023 511345 Twin Sharing 1 1200.00 0.00 1200.00
307703 322675 03/08/2023 07/08/2023 Mrs. ARLENE CREADO 2602 03/08/2023 511324 Single Ac Room 1 1200.00 0.00 1200.00

REV. DATE: 4/08/2023 20790.00 0.00 20790.00

CHARGE CODE: 96 - Blood Bank 20790.00 0.00 20790.00
SERVICE CODE : 9600004 - FFP Process Charges 0.00 0.00 0.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2599 03/08/2023 511318 Single Ac Room -4 -2800.00 0.00 -2800.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2599 03/08/2023 511364 Single Ac Room 4 2800.00 0.00 2800.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2601 03/08/2023 511318 Single Ac Room -2 -1400.00 0.00 -1400.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2601 03/08/2023 511364 Single Ac Room 2 1400.00 0.00 1400.00
SERVICE CODE : 9600010 - PRBC Service Charges 4800.00 0.00 4800.00
307722 313962 04/08/2023 08/08/2023 Mrs. FARHANA WARSI 2607 04/08/2023 511425 Single Ac Room 1 1200.00 0.00 1200.00
307734 318546 04/08/2023 07/08/2023 Mrs. SHEFALI PATHAK 2611 04/08/2023 511396 Single Ac Room 1 1200.00 0.00 1200.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2598 03/08/2023 511318 Single Ac Room -1 -1200.00 0.00 -1200.00
Date : 07/09/2023 Page 2 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2598 03/08/2023 511364 Single Ac Room 1 1200.00 0.00 1200.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2603 03/08/2023 511318 Single Ac Room -2 -2400.00 0.00 -2400.00
307681 319924 02/08/2023 05/08/2023 Mrs. SWATI LATH 2603 03/08/2023 511364 Single Ac Room 2 2400.00 0.00 2400.00
306971 320735 20/06/2023 30/06/2023 Female Baby Of ANITA SAUTKAR 2609 04/08/2023 0 NICU 1 1200.00 0.00 1200.00
307697 322272 03/08/2023 05/08/2023 Mrs. MADHU JAIN 2597 03/08/2023 511317 Single Ac Room -1 -1200.00 0.00 -1200.00
307697 322272 03/08/2023 05/08/2023 Mrs. MADHU JAIN 2597 03/08/2023 511360 Single Ac Room 1 1200.00 0.00 1200.00
307703 322675 03/08/2023 07/08/2023 Mrs. ARLENE CREADO 2602 03/08/2023 511324 Single Ac Room -1 -1200.00 0.00 -1200.00
307703 322675 03/08/2023 07/08/2023 Mrs. ARLENE CREADO 2602 03/08/2023 511383 Single Ac Room 1 1200.00 0.00 1200.00
307719 322719 04/08/2023 07/08/2023 Mrs. GITA VAIDYA 2606 04/08/2023 511388 Twin Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00 4500.00
306971 320735 20/06/2023 30/06/2023 Female Baby Of ANITA SAUTKAR 2613 04/08/2023 0 NICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 8460.00 0.00 8460.00
307674 33421 02/08/2023 11/08/2023 Mrs. KAVITA SHARMA 2608 04/08/2023 511494 Single Ac Room 1 4230.00 0.00 4230.00
307728 322740 04/08/2023 06/08/2023 Mrs. SHRUTI RAMCHANDRA GAVADE 2610 04/08/2023 511373 Twin Sharing 1 4230.00 0.00 4230.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00 3030.00
307674 33421 02/08/2023 11/08/2023 Mrs. KAVITA SHARMA 2612 04/08/2023 511494 Single Ac Room 1 3030.00 0.00 3030.00

REV. DATE: 5/08/2023 8860.00 0.00 8860.00

CHARGE CODE: 96 - Blood Bank 8860.00 0.00 8860.00
SERVICE CODE : 9600005 - FFP Service Charges 400.00 0.00 400.00
307745 322771 05/08/2023 08/08/2023 Mrs. DIMPLE RAJU SHARMA 2615 05/08/2023 511433 Single Ac Room 2 400.00 0.00 400.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00 2400.00
307755 319874 05/08/2023 08/08/2023 Dr. (Mrs.) SAYLI WANKHEDKAR 2617 05/08/2023 511419 Single Ac Room 1 1200.00 0.00 1200.00
307745 322771 05/08/2023 08/08/2023 Mrs. DIMPLE RAJU SHARMA 2615 05/08/2023 511433 Single Ac Room 1 1200.00 0.00 1200.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 6060.00 0.00 6060.00
307728 322740 04/08/2023 06/08/2023 Mrs. SHRUTI RAMCHANDRA GAVADE 2614 05/08/2023 511373 Twin Sharing 1 3030.00 0.00 3030.00
307728 322740 04/08/2023 06/08/2023 Mrs. SHRUTI RAMCHANDRA GAVADE 2616 05/08/2023 511373 Twin Sharing 1 3030.00 0.00 3030.00

REV. DATE: 6/08/2023 8730.00 0.00 8730.00

CHARGE CODE: 96 - Blood Bank 8730.00 0.00 8730.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00 4500.00
307720 322720 04/08/2023 13/08/2023 Female Baby Of SANGEETA LODHA JAIN 2619 06/08/2023 511541 NICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00 4230.00
307742 322769 05/08/2023 21/08/2023 Baby DHRUVI PARIKSHIT DHOKARE 2618 06/08/2023 511743 PICU 1 4230.00 0.00 4230.00

REV. DATE: 7/08/2023 2400.00 0.00 2400.00

CHARGE CODE: 96 - Blood Bank 2400.00 0.00 2400.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00 2400.00
307775 116384 07/08/2023 10/08/2023 Mrs. PRACHI JAIN 2620 07/08/2023 511465 Single Ac Room 1 1200.00 0.00 1200.00
307768 313873 06/08/2023 10/08/2023 Mrs. RUCHI BINOY MEHTA 2621 07/08/2023 511468 Single Ac Room 1 1200.00 0.00 1200.00

REV. DATE: 8/08/2023 21660.00 0.00 21660.00

CHARGE CODE: 96 - Blood Bank 21660.00 0.00 21660.00
SERVICE CODE : 9600004 - FFP Process Charges 700.00 0.00 700.00
307764 322840 06/08/2023 09/08/2023 Baby MADHURA UDAIYAR 2626 08/08/2023 0 PICU 1 700.00 0.00 700.00
Date : 07/09/2023 Page 3 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
SERVICE CODE : 9600006 - Irradiation 1200.00 0.00 1200.00
307769 321487 06/08/2023 08/08/2023 Miss. KHWAISH RISHI BAHRI 2625 08/08/2023 0 PICU 1 1200.00 0.00 1200.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00 2400.00
307793 319342 07/08/2023 11/08/2023 Mrs. SHERRAL PEREIRA 2622 08/08/2023 511492 Twin Sharing 1 1200.00 0.00 1200.00
307810 319567 08/08/2023 11/08/2023 Mrs. VAISHALI NAIK 2627 08/08/2023 511446 Single Ac Room 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00 4500.00
307805 322939 08/08/2023 12/08/2023 Baby ADISHREE RATHORE 2624 08/08/2023 511572 PICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600012 - RDP Process Charges 2800.00 0.00 2800.00
307764 322840 06/08/2023 09/08/2023 Baby MADHURA UDAIYAR 2626 08/08/2023 0 PICU 4 2800.00 0.00 2800.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 8460.00 0.00 8460.00
307786 320978 07/08/2023 19/08/2023 Baba ANHAD HARSH 2623 08/08/2023 511691 Twin Sharing 1 4230.00 0.00 4230.00
307769 321487 06/08/2023 08/08/2023 Miss. KHWAISH RISHI BAHRI 2625 08/08/2023 0 PICU 1 4230.00 0.00 4230.00
SERVICE CODE : 9600016 - RDP Service Charges 1600.00 0.00 1600.00
307764 322840 06/08/2023 09/08/2023 Baby MADHURA UDAIYAR 2626 08/08/2023 0 PICU 4 1600.00 0.00 1600.00

REV. DATE: 9/08/2023 20160.00 0.00 20160.00

CHARGE CODE: 96 - Blood Bank 20160.00 0.00 20160.00
SERVICE CODE : 9600010 - PRBC Service Charges 7200.00 0.00 7200.00
307809 311393 08/08/2023 14/08/2023 Mrs. JABA MISRA 2628 09/08/2023 511561 Suite Marigold 1 1200.00 0.00 1200.00
307810 319567 08/08/2023 11/08/2023 Mrs. VAISHALI NAIK 2627 08/08/2023 511446 Single Ac Room -1 -1200.00 0.00 -1200.00
307810 319567 08/08/2023 11/08/2023 Mrs. VAISHALI NAIK 2627 08/08/2023 511502 Single Ac Room 1 1200.00 0.00 1200.00
307816 321055 09/08/2023 12/08/2023 Mrs. RASHMI SUNIL KAMBLE 2632 09/08/2023 511534 Twin Sharing 1 1200.00 0.00 1200.00
307821 321057 09/08/2023 13/08/2023 Mrs. MEENA JOSHI 2635 09/08/2023 511481 Twin Sharing 1 1200.00 0.00 1200.00
307764 322840 06/08/2023 09/08/2023 Baby MADHURA UDAIYAR 2629 09/08/2023 0 PICU 1 1200.00 0.00 1200.00
307815 322966 09/08/2023 12/08/2023 Mast KRISHAY KETAN SHAH 2631 09/08/2023 511458 Single Ac Room 1 1200.00 0.00 1200.00
307815 322966 09/08/2023 12/08/2023 Mast KRISHAY KETAN SHAH 2631 09/08/2023 511458 Single Ac Room -1 -1200.00 0.00 -1200.00
307815 322966 09/08/2023 12/08/2023 Mast KRISHAY KETAN SHAH 2631 09/08/2023 511525 Single Ac Room 1 1200.00 0.00 1200.00
307818 322969 09/08/2023 12/08/2023 Mr. THOMAS K MATHEW 2630 09/08/2023 511517 Single Ac Room 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00 4500.00
307805 322939 08/08/2023 12/08/2023 Baby ADISHREE RATHORE 2634 09/08/2023 511572 PICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 8460.00 0.00 8460.00
307815 322966 09/08/2023 12/08/2023 Mast KRISHAY KETAN SHAH 2633 09/08/2023 511525 Single Ac Room 2 8460.00 0.00 8460.00

REV. DATE: 10/08/2023 15330.00 0.00 15330.00

CHARGE CODE: 96 - Blood Bank 15330.00 0.00 15330.00
SERVICE CODE : 9600004 - FFP Process Charges 700.00 0.00 700.00
307805 322939 08/08/2023 12/08/2023 Baby ADISHREE RATHORE 2644 10/08/2023 511572 PICU 1 700.00 0.00 700.00
SERVICE CODE : 9600010 - PRBC Service Charges 7200.00 0.00 7200.00
307827 31249 09/08/2023 13/08/2023 Mrs. SMRUTI SATYASHARAN UMARANI 2641 10/08/2023 511548 Single Ac Room 1 1200.00 0.00 1200.00
307823 291024 09/08/2023 14/08/2023 Mrs. BHARTI AKASH SARDA 2637 10/08/2023 511563 Single Ac Room 1 1200.00 0.00 1200.00
307835 319451 10/08/2023 13/08/2023 Mrs. CHEZ SHETTY 2642 10/08/2023 511543 Suite Lotus 1 1200.00 0.00 1200.00
307821 321057 09/08/2023 13/08/2023 Mrs. MEENA JOSHI 2635 09/08/2023 511481 Twin Sharing -1 -1200.00 0.00 -1200.00
307821 321057 09/08/2023 13/08/2023 Mrs. MEENA JOSHI 2635 09/08/2023 511617 Twin Sharing 1 1200.00 0.00 1200.00
307829 321095 10/08/2023 13/08/2023 Miss. SAYLI HEMANT ANAVKAR 2640 10/08/2023 511547 Single Ac Room 1 1200.00 0.00 1200.00
307826 321270 09/08/2023 12/08/2023 Mrs. ASMITA KALPESH KACHA 2638 10/08/2023 511527 Twin Sharing 1 1200.00 0.00 1200.00
Date : 07/09/2023 Page 4 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
307830 323023 10/08/2023 14/08/2023 Mrs. SWARA KISHOR SHELAR 2639 10/08/2023 511495 Twin Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600012 - RDP Process Charges 2800.00 0.00 2800.00
307805 322939 08/08/2023 12/08/2023 Baby ADISHREE RATHORE 2636 10/08/2023 511572 PICU 4 2800.00 0.00 2800.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00 3030.00
307742 322769 05/08/2023 21/08/2023 Baby DHRUVI PARIKSHIT DHOKARE 2643 10/08/2023 511743 PICU 1 3030.00 0.00 3030.00
SERVICE CODE : 9600016 - RDP Service Charges 1600.00 0.00 1600.00
307805 322939 08/08/2023 12/08/2023 Baby ADISHREE RATHORE 2636 10/08/2023 511572 PICU 4 1600.00 0.00 1600.00

REV. DATE: 11/08/2023 18300.00 0.00 18300.00

CHARGE CODE: 96 - Blood Bank 18300.00 0.00 18300.00
SERVICE CODE : 9600010 - PRBC Service Charges 6000.00 0.00 6000.00
307871 320551 11/08/2023 12/08/2023 Mrs. ADITI DIDWANIA 2650 11/08/2023 511539 Twin Sharing 1 1200.00 0.00 1200.00
307742 322769 05/08/2023 21/08/2023 Baby DHRUVI PARIKSHIT DHOKARE 2648 11/08/2023 511743 PICU 2 2400.00 0.00 2400.00
307863 322931 11/08/2023 14/08/2023 Mrs. KHUSHBOO VARUN PARASRAMPURIA 2647 11/08/2023 511552 Single Ac Room 2 2400.00 0.00 2400.00
307830 323023 10/08/2023 14/08/2023 Mrs. SWARA KISHOR SHELAR 2639 10/08/2023 511495 Twin Sharing -1 -1200.00 0.00 -1200.00
307830 323023 10/08/2023 14/08/2023 Mrs. SWARA KISHOR SHELAR 2639 10/08/2023 511557 Twin Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 9000.00 0.00 9000.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2649 11/08/2023 511802 Twin Sharing 1 4500.00 0.00 4500.00
307805 322939 08/08/2023 12/08/2023 Baby ADISHREE RATHORE 2646 11/08/2023 511572 PICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600012 - RDP Process Charges 2100.00 0.00 2100.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2645 11/08/2023 511802 Twin Sharing 1 700.00 0.00 700.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2649 11/08/2023 511802 Twin Sharing 2 1400.00 0.00 1400.00
SERVICE CODE : 9600016 - RDP Service Charges 1200.00 0.00 1200.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2649 11/08/2023 511802 Twin Sharing 2 800.00 0.00 800.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2645 11/08/2023 511802 Twin Sharing 1 400.00 0.00 400.00

REV. DATE: 12/08/2023 34560.00 0.00 34560.00

CHARGE CODE: 96 - Blood Bank 34560.00 0.00 34560.00
SERVICE CODE : 9600006 - Irradiation 1200.00 0.00 1200.00
307888 279949 12/08/2023 13/08/2023 Miss. THRIDA MAHESH JADHAV 2658 12/08/2023 511544 Triple Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600010 - PRBC Service Charges 7200.00 0.00 7200.00
307873 312215 11/08/2023 16/08/2023 Dr. (Mrs.) HEMASHRI CHATURVEDI 2652 12/08/2023 511593 Single Ac Room 2 2400.00 0.00 2400.00
307874 317442 11/08/2023 15/08/2023 Mrs. ALFIYA THAVER 2653 12/08/2023 511585 Single Ac Room 1 1200.00 0.00 1200.00
307875 319728 12/08/2023 14/08/2023 Mrs. AKSHATA JADHAV 2654 12/08/2023 511568 Twin Sharing 1 1200.00 0.00 1200.00
307894 321112 12/08/2023 16/08/2023 Mrs. SMITA GAJANE 2662 12/08/2023 511602 Twin Sharing 1 1200.00 0.00 1200.00
307885 322054 12/08/2023 14/08/2023 Mrs. MADHAVI RAHUL SHAH 2656 12/08/2023 511571 Twin Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 9000.00 0.00 9000.00
307786 320978 07/08/2023 19/08/2023 Baba ANHAD HARSH 2657 12/08/2023 511691 Twin Sharing 1 4500.00 0.00 4500.00
307889 323152 12/08/2023 22/08/2023 Male Baby Of KIRAN SRIVASTAVA 2661 12/08/2023 0 NICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600012 - RDP Process Charges 6300.00 0.00 6300.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2651 12/08/2023 511802 Twin Sharing 2 1400.00 0.00 1400.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2659 12/08/2023 511802 Twin Sharing 1 700.00 0.00 700.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2660 12/08/2023 511802 Twin Sharing 2 1400.00 0.00 1400.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2655 12/08/2023 511526 Triple Sharing 4 2800.00 0.00 2800.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2655 12/08/2023 511526 Triple Sharing -4 -2800.00 0.00 -2800.00
Date : 07/09/2023 Page 5 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2655 12/08/2023 511838 Triple Sharing 4 2800.00 0.00 2800.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00 4230.00
307888 279949 12/08/2023 13/08/2023 Miss. THRIDA MAHESH JADHAV 2658 12/08/2023 511544 Triple Sharing 1 4230.00 0.00 4230.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00 3030.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2655 12/08/2023 511526 Triple Sharing 1 3030.00 0.00 3030.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2655 12/08/2023 511526 Triple Sharing -1 -3030.00 0.00 -3030.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2655 12/08/2023 511838 Triple Sharing 1 3030.00 0.00 3030.00
SERVICE CODE : 9600016 - RDP Service Charges 3600.00 0.00 3600.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2651 12/08/2023 511802 Twin Sharing 2 800.00 0.00 800.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2659 12/08/2023 511802 Twin Sharing 1 400.00 0.00 400.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2660 12/08/2023 511802 Twin Sharing 2 800.00 0.00 800.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2655 12/08/2023 511526 Triple Sharing 4 1600.00 0.00 1600.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2655 12/08/2023 511526 Triple Sharing -4 -1600.00 0.00 -1600.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2655 12/08/2023 511838 Triple Sharing 4 1600.00 0.00 1600.00

REV. DATE: 13/08/2023 11630.00 0.00 11630.00

CHARGE CODE: 96 - Blood Bank 11630.00 0.00 11630.00
SERVICE CODE : 9600004 - FFP Process Charges 700.00 0.00 700.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2664 13/08/2023 511802 Twin Sharing 1 700.00 0.00 700.00
SERVICE CODE : 9600010 - PRBC Service Charges 1200.00 0.00 1200.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2666 13/08/2023 511802 Twin Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600012 - RDP Process Charges 3500.00 0.00 3500.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2664 13/08/2023 511802 Twin Sharing 4 2800.00 0.00 2800.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2665 13/08/2023 511838 Triple Sharing 1 700.00 0.00 700.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00 4230.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2663 13/08/2023 511838 Triple Sharing 1 4230.00 0.00 4230.00
SERVICE CODE : 9600016 - RDP Service Charges 2000.00 0.00 2000.00
307849 293477 10/08/2023 24/08/2023 Mast DHRISH KISNADWALA 2664 13/08/2023 511802 Twin Sharing 4 1600.00 0.00 1600.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2665 13/08/2023 511838 Triple Sharing 1 400.00 0.00 400.00

REV. DATE: 14/08/2023 9600.00 0.00 9600.00

CHARGE CODE: 96 - Blood Bank 9600.00 0.00 9600.00
SERVICE CODE : 9600010 - PRBC Service Charges 9600.00 0.00 9600.00
307902 118321 14/08/2023 17/08/2023 Mrs. TASHWEEN WADERA 2667 14/08/2023 511621 Single Ac Room 1 1200.00 0.00 1200.00
307900 315772 13/08/2023 17/08/2023 Mrs. SWATI KAMAT 2668 14/08/2023 511618 Suite Lotus 1 1200.00 0.00 1200.00
307906 318194 14/08/2023 17/08/2023 Mrs. PRIYANKA RANE 2669 14/08/2023 511565 Single Ac Room -1 -1200.00 0.00 -1200.00
307906 318194 14/08/2023 17/08/2023 Mrs. PRIYANKA RANE 2669 14/08/2023 511610 Single Ac Room 1 1200.00 0.00 1200.00
307906 318194 14/08/2023 17/08/2023 Mrs. PRIYANKA RANE 2669 14/08/2023 511565 Single Ac Room 1 1200.00 0.00 1200.00
307875 319728 12/08/2023 14/08/2023 Mrs. AKSHATA JADHAV 2654 12/08/2023 511568 Twin Sharing -1 -1200.00 0.00 -1200.00
307875 319728 12/08/2023 14/08/2023 Mrs. AKSHATA JADHAV 2654 12/08/2023 511570 Twin Sharing 1 1200.00 0.00 1200.00
307904 320230 14/08/2023 17/08/2023 Mrs. ANISHA NAMBIR NALOTIA 2670 14/08/2023 511611 Single Ac Room 1 1200.00 0.00 1200.00
307913 321667 14/08/2023 16/08/2023 Mrs. HEMALI LAPSIWALA 2671 14/08/2023 511609 Twin Sharing 2 2400.00 0.00 2400.00
307918 323243 14/08/2023 18/08/2023 Mrs. DIPTI PATEL 2672 14/08/2023 511661 Triple Sharing 2 2400.00 0.00 2400.00

REV. DATE: 15/08/2023 18300.00 0.00 18300.00

CHARGE CODE: 96 - Blood Bank 18300.00 0.00 18300.00
Date : 07/09/2023 Page 6 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
SERVICE CODE : 9600010 - PRBC Service Charges 4800.00 0.00 4800.00
307930 264435 15/08/2023 18/08/2023 Mast SWARAJ WADKAR 2678 15/08/2023 511604 Triple Sharing 1 1200.00 0.00 1200.00
307925 320666 15/08/2023 18/08/2023 Mrs. SHRADDHA PRAJIT GANDHI 2676 15/08/2023 511653 Single Ac Room 1 1200.00 0.00 1200.00
307925 320666 15/08/2023 18/08/2023 Mrs. SHRADDHA PRAJIT GANDHI 2677 15/08/2023 0 Single Ac Room 1 1200.00 0.00 1200.00
307919 323251 14/08/2023 17/08/2023 Mrs. ASAVARI NARENDRA DURVE 2675 15/08/2023 511630 Single Ac Room 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 13500.00 0.00 13500.00
307786 320978 07/08/2023 19/08/2023 Baba ANHAD HARSH 2674 15/08/2023 511691 Twin Sharing 1 4500.00 0.00 4500.00
307607 322423 28/07/2023 07/08/2023 Male Baby Of MAYURI DOUNDE 2679 15/08/2023 0 NICU 1 4500.00 0.00 4500.00
307742 322769 05/08/2023 21/08/2023 Baby DHRUVI PARIKSHIT DHOKARE 2673 15/08/2023 511743 PICU 1 4500.00 0.00 4500.00

REV. DATE: 16/08/2023 4800.00 0.00 4800.00

CHARGE CODE: 96 - Blood Bank 4800.00 0.00 4800.00
SERVICE CODE : 9600010 - PRBC Service Charges 4800.00 0.00 4800.00
307942 148431 16/08/2023 19/08/2023 Mrs. ZARA QURESHI 2682 16/08/2023 511685 Single Ac Room 1 1200.00 0.00 1200.00
307930 264435 15/08/2023 18/08/2023 Mast SWARAJ WADKAR 2678 15/08/2023 511604 Triple Sharing -1 -1200.00 0.00 -1200.00
307930 264435 15/08/2023 18/08/2023 Mast SWARAJ WADKAR 2678 15/08/2023 511656 Triple Sharing 1 1200.00 0.00 1200.00
307926 279308 15/08/2023 19/08/2023 Mrs. AKSHATHA VARUN SAXENA 2680 16/08/2023 511678 Suite Marigold 1 1200.00 0.00 1200.00
307873 312215 11/08/2023 16/08/2023 Dr. (Mrs.) HEMASHRI CHATURVEDI 2652 12/08/2023 511593 Single Ac Room -2 -2400.00 0.00 -2400.00
307873 312215 11/08/2023 16/08/2023 Dr. (Mrs.) HEMASHRI CHATURVEDI 2652 12/08/2023 511595 Single Ac Room 2 2400.00 0.00 2400.00
307911 312551 14/08/2023 21/08/2023 Mrs. DIPIKA SAGAR JADHAV 2683 16/08/2023 511727 Twin Sharing 1 1200.00 0.00 1200.00
307928 323290 15/08/2023 18/08/2023 Mrs. RASHMI VIJAY SIRSAT 2681 16/08/2023 511669 Twin Sharing 1 1200.00 0.00 1200.00

REV. DATE: 17/08/2023 8200.00 0.00 8200.00

CHARGE CODE: 96 - Blood Bank 8200.00 0.00 8200.00
SERVICE CODE : 9600010 - PRBC Service Charges 6000.00 0.00 6000.00
307935 308413 16/08/2023 20/08/2023 Dr. (Mrs.) SUPRIYA SHARMA 2684 17/08/2023 511616 Single Ac Room 1 1200.00 0.00 1200.00
307935 308413 16/08/2023 20/08/2023 Dr. (Mrs.) SUPRIYA SHARMA 2684 17/08/2023 511616 Single Ac Room -1 -1200.00 0.00 -1200.00
307935 308413 16/08/2023 20/08/2023 Dr. (Mrs.) SUPRIYA SHARMA 2684 17/08/2023 511680 Single Ac Room 1 1200.00 0.00 1200.00
307900 315772 13/08/2023 17/08/2023 Mrs. SWATI KAMAT 2668 14/08/2023 511618 Suite Lotus -1 -1200.00 0.00 -1200.00
307900 315772 13/08/2023 17/08/2023 Mrs. SWATI KAMAT 2668 14/08/2023 511620 Suite Lotus 1 1200.00 0.00 1200.00
307959 320309 17/08/2023 21/08/2023 Mrs. SPOORTHI TAMMAREDDI 2687 17/08/2023 511671 Suite Daffodil 1 1200.00 0.00 1200.00
307956 323126 17/08/2023 19/08/2023 Mrs. DRISHTI MALPESH VED 2686 17/08/2023 511636 Single Ac Room -1 -1200.00 0.00 -1200.00
307956 323126 17/08/2023 19/08/2023 Mrs. DRISHTI MALPESH VED 2686 17/08/2023 511673 Single Ac Room 1 1200.00 0.00 1200.00
307956 323126 17/08/2023 19/08/2023 Mrs. DRISHTI MALPESH VED 2686 17/08/2023 511636 Single Ac Room 1 1200.00 0.00 1200.00
307949 323354 16/08/2023 20/08/2023 Mrs. ADITI AJIT YEDRE 2685 17/08/2023 511633 Single Ac Room 1 1200.00 0.00 1200.00
307949 323354 16/08/2023 20/08/2023 Mrs. ADITI AJIT YEDRE 2685 17/08/2023 511633 Single Ac Room -1 -1200.00 0.00 -1200.00
307949 323354 16/08/2023 20/08/2023 Mrs. ADITI AJIT YEDRE 2685 17/08/2023 511771 Single Ac Room 1 1200.00 0.00 1200.00
307961 323381 17/08/2023 19/08/2023 Mrs. POOJA SHAH 2688 17/08/2023 511666 Twin Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600012 - RDP Process Charges 1400.00 0.00 1400.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2689 17/08/2023 511838 Triple Sharing 2 1400.00 0.00 1400.00
SERVICE CODE : 9600016 - RDP Service Charges 800.00 0.00 800.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2689 17/08/2023 511838 Triple Sharing 2 800.00 0.00 800.00

REV. DATE: 18/08/2023 24330.00 0.00 24330.00

CHARGE CODE: 96 - Blood Bank 24330.00 0.00 24330.00
SERVICE CODE : 9600004 - FFP Process Charges 1400.00 0.00 1400.00
307950 323357 16/08/2023 28/08/2023 Miss. AHAANA SAHASRABUDDHE 2695 18/08/2023 511664 Single Ac Room 2 1400.00 0.00 1400.00
307950 323357 16/08/2023 28/08/2023 Miss. AHAANA SAHASRABUDDHE 2695 18/08/2023 511664 Single Ac Room -2 -1400.00 0.00 -1400.00
307950 323357 16/08/2023 28/08/2023 Miss. AHAANA SAHASRABUDDHE 2695 18/08/2023 511915 Single Ac Room 2 1400.00 0.00 1400.00
Date : 07/09/2023 Page 7 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
SERVICE CODE : 9600010 - PRBC Service Charges 13200.00 0.00 13200.00
307977 115637 18/08/2023 22/08/2023 Mrs. PALLAVI SRIVASTAVA RAMCHANDANI 2699 18/08/2023 511670 Twin Sharing -2 -2400.00 0.00 -2400.00
307977 115637 18/08/2023 22/08/2023 Mrs. PALLAVI SRIVASTAVA RAMCHANDANI 2699 18/08/2023 511755 Twin Sharing 2 2400.00 0.00 2400.00
307977 115637 18/08/2023 22/08/2023 Mrs. PALLAVI SRIVASTAVA RAMCHANDANI 2699 18/08/2023 511670 Twin Sharing 2 2400.00 0.00 2400.00
307972 264669 18/08/2023 21/08/2023 Mrs. BHARTI HARILAL PATEL 2697 18/08/2023 511724 Single Ac Room 1 1200.00 0.00 1200.00
307971 308098 18/08/2023 20/08/2023 Mrs. ASHA RAMANAND MACHEWAD 2698 18/08/2023 511708 Single Ac Room 1 1200.00 0.00 1200.00
307984 319860 18/08/2023 21/08/2023 Mrs. SUKANYA POWALE 2702 18/08/2023 511676 Single Ac Room 1 1200.00 0.00 1200.00
307959 320309 17/08/2023 21/08/2023 Mrs. SPOORTHI TAMMAREDDI 2703 18/08/2023 511719 Suite Daffodil 1 1200.00 0.00 1200.00
307993 320502 18/08/2023 22/08/2023 Mrs. SRUSHTI VIJAY NARE 2704 18/08/2023 511753 Twin Sharing 1 1200.00 0.00 1200.00
307925 320666 15/08/2023 18/08/2023 Mrs. SHRADDHA PRAJIT GANDHI 2677 15/08/2023 0 Single Ac Room -1 -1200.00 0.00 -1200.00
307962 321832 17/08/2023 22/08/2023 Mrs. LAVINA VIDHANI 2691 18/08/2023 511660 Single Ac Room 1 1200.00 0.00 1200.00
307962 321832 17/08/2023 22/08/2023 Mrs. LAVINA VIDHANI 2691 18/08/2023 511660 Single Ac Room -1 -1200.00 0.00 -1200.00
307962 321832 17/08/2023 22/08/2023 Mrs. LAVINA VIDHANI 2691 18/08/2023 511749 Single Ac Room 1 1200.00 0.00 1200.00
307968 322175 17/08/2023 19/08/2023 Mrs. SAKSHI ARORA 2690 18/08/2023 511692 Single Ac Room 1 1200.00 0.00 1200.00
307980 322225 18/08/2023 21/08/2023 Mrs. PRERNA HARDIK DASANI 2701 18/08/2023 511726 Single Ac Room 1 1200.00 0.00 1200.00
307965 323164 17/08/2023 21/08/2023 Mrs. KAVITA KUMARI 2692 18/08/2023 511642 Twin Sharing 1 1200.00 0.00 1200.00
307965 323164 17/08/2023 21/08/2023 Mrs. KAVITA KUMARI 2692 18/08/2023 511642 Twin Sharing -1 -1200.00 0.00 -1200.00
307965 323164 17/08/2023 21/08/2023 Mrs. KAVITA KUMARI 2692 18/08/2023 511720 Twin Sharing 1 1200.00 0.00 1200.00
307961 323381 17/08/2023 19/08/2023 Mrs. POOJA SHAH 2688 17/08/2023 511666 Twin Sharing -1 -1200.00 0.00 -1200.00
307961 323381 17/08/2023 19/08/2023 Mrs. POOJA SHAH 2688 17/08/2023 511682 Twin Sharing 1 1200.00 0.00 1200.00
307981 323434 18/08/2023 20/08/2023 Mrs. MAYURI CHADDHA 2700 18/08/2023 511785 Single Ac Room 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00 4500.00
307742 322769 05/08/2023 21/08/2023 Baby DHRUVI PARIKSHIT DHOKARE 2696 18/08/2023 511743 PICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600012 - RDP Process Charges 1400.00 0.00 1400.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2693 18/08/2023 511838 Triple Sharing 2 1400.00 0.00 1400.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00 3030.00
307950 323357 16/08/2023 28/08/2023 Miss. AHAANA SAHASRABUDDHE 2694 18/08/2023 511664 Single Ac Room 1 3030.00 0.00 3030.00
307950 323357 16/08/2023 28/08/2023 Miss. AHAANA SAHASRABUDDHE 2694 18/08/2023 511664 Single Ac Room -1 -3030.00 0.00 -3030.00
307950 323357 16/08/2023 28/08/2023 Miss. AHAANA SAHASRABUDDHE 2694 18/08/2023 511915 Single Ac Room 1 3030.00 0.00 3030.00
SERVICE CODE : 9600016 - RDP Service Charges 800.00 0.00 800.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2693 18/08/2023 511838 Triple Sharing 2 800.00 0.00 800.00

REV. DATE: 19/08/2023 5700.00 0.00 5700.00

CHARGE CODE: 96 - Blood Bank 5700.00 0.00 5700.00
SERVICE CODE : 9600010 - PRBC Service Charges 1200.00 0.00 1200.00
307935 308413 16/08/2023 20/08/2023 Dr. (Mrs.) SUPRIYA SHARMA 2684 17/08/2023 511696 Single Ac Room -1 -1200.00 0.00 -1200.00
307935 308413 16/08/2023 20/08/2023 Dr. (Mrs.) SUPRIYA SHARMA 2684 17/08/2023 511702 Single Ac Room 1 1200.00 0.00 1200.00
307995 314354 19/08/2023 21/08/2023 Mrs. RAJSHREE PAWSE 2705 19/08/2023 511712 Twin Sharing 1 1200.00 0.00 1200.00
307984 319860 18/08/2023 21/08/2023 Mrs. SUKANYA POWALE 2702 18/08/2023 511676 Single Ac Room -1 -1200.00 0.00 -1200.00
307984 319860 18/08/2023 21/08/2023 Mrs. SUKANYA POWALE 2702 18/08/2023 511710 Single Ac Room 1 1200.00 0.00 1200.00
307959 320309 17/08/2023 21/08/2023 Mrs. SPOORTHI TAMMAREDDI 2687 17/08/2023 511671 Suite Daffodil -1 -1200.00 0.00 -1200.00
307959 320309 17/08/2023 21/08/2023 Mrs. SPOORTHI TAMMAREDDI 2687 17/08/2023 511719 Suite Daffodil 1 1200.00 0.00 1200.00
307968 322175 17/08/2023 19/08/2023 Mrs. SAKSHI ARORA 2690 18/08/2023 511692 Single Ac Room -1 -1200.00 0.00 -1200.00
307968 322175 17/08/2023 19/08/2023 Mrs. SAKSHI ARORA 2690 18/08/2023 511694 Single Ac Room 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00 4500.00
308004 318316 19/08/2023 20/08/2023 Baby YUKTI SAJNANI 2706 19/08/2023 511706 Twin Sharing 1 4500.00 0.00 4500.00
Date : 07/09/2023 Page 8 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
REV. DATE: 20/08/2023 3500.00 0.00 3500.00
CHARGE CODE: 96 - Blood Bank 3500.00 0.00 3500.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00 2400.00
308010 314005 20/08/2023 01/09/2023 Mrs. SNEHA PANKAJ DAWARE 2707 20/08/2023 512002 Suite Daffodil 1 1200.00 0.00 1200.00
308010 314005 20/08/2023 01/09/2023 Mrs. SNEHA PANKAJ DAWARE 2708 20/08/2023 512002 Suite Daffodil 1 1200.00 0.00 1200.00
SERVICE CODE : 9600012 - RDP Process Charges 700.00 0.00 700.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2709 20/08/2023 511838 Triple Sharing 1 700.00 0.00 700.00
SERVICE CODE : 9600016 - RDP Service Charges 400.00 0.00 400.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2709 20/08/2023 511838 Triple Sharing 1 400.00 0.00 400.00

REV. DATE: 21/08/2023 2400.00 0.00 2400.00

CHARGE CODE: 96 - Blood Bank 2400.00 0.00 2400.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00 2400.00
307980 322225 18/08/2023 21/08/2023 Mrs. PRERNA HARDIK DASANI 2701 18/08/2023 511740 Single Ac Room -1 -1200.00 0.00 -1200.00
307980 322225 18/08/2023 21/08/2023 Mrs. PRERNA HARDIK DASANI 2701 18/08/2023 511742 Single Ac Room 1 1200.00 0.00 1200.00
307990 323454 18/08/2023 29/08/2023 Mast ANMOL ROY 2710 21/08/2023 511936 Triple Sharing 1 1200.00 0.00 1200.00
308031 323594 21/08/2023 23/08/2023 Mrs. SHIVANI SHAH 2711 21/08/2023 511777 Single Ac Room 1 1200.00 0.00 1200.00

REV. DATE: 22/08/2023 12800.00 0.00 12800.00

CHARGE CODE: 96 - Blood Bank 12800.00 0.00 12800.00
SERVICE CODE : 9600010 - PRBC Service Charges 7200.00 0.00 7200.00
308060 298856 22/08/2023 25/08/2023 Mrs. NIDHI KOTAK 2718 22/08/2023 511830 Single Ac Room 1 1200.00 0.00 1200.00
308061 313692 22/08/2023 26/08/2023 Mrs. ARCHANA PEREIRA 2719 22/08/2023 511781 Single Ac Room 1 1200.00 0.00 1200.00
308010 314005 20/08/2023 01/09/2023 Mrs. SNEHA PANKAJ DAWARE 2712 22/08/2023 512002 Suite Daffodil 1 1200.00 0.00 1200.00
308038 320753 22/08/2023 25/08/2023 Mrs. KRUPA THAKKER 2715 22/08/2023 511831 Single Ac Room 1 1200.00 0.00 1200.00
308053 321483 22/08/2023 25/08/2023 Mrs. MILI PRATHAM SHAH 2717 22/08/2023 511828 Single Ac Room 1 1200.00 0.00 1200.00
307582 322369 27/07/2023 25/08/2023 Mrs. PRIYANKA RATHI 2713 22/08/2023 511822 Single Ac Room 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00 4500.00
307999 323469 19/08/2023 04/09/2023 Male Baby Of RAJSHREE PAWSE 2716 22/08/2023 511913 NICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600012 - RDP Process Charges 700.00 0.00 700.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2714 22/08/2023 511838 Triple Sharing 1 700.00 0.00 700.00
SERVICE CODE : 9600016 - RDP Service Charges 400.00 0.00 400.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2714 22/08/2023 511838 Triple Sharing 1 400.00 0.00 400.00

REV. DATE: 23/08/2023 20630.00 0.00 20630.00

CHARGE CODE: 96 - Blood Bank 20630.00 0.00 20630.00
SERVICE CODE : 9600010 - PRBC Service Charges 10800.00 0.00 10800.00
308061 313692 22/08/2023 26/08/2023 Mrs. ARCHANA PEREIRA 2719 22/08/2023 511781 Single Ac Room -1 -1200.00 0.00 -1200.00
308061 313692 22/08/2023 26/08/2023 Mrs. ARCHANA PEREIRA 2719 22/08/2023 511885 Single Ac Room 1 1200.00 0.00 1200.00
308056 321496 22/08/2023 26/08/2023 Mrs. SHRADHA SURAJ KOKANE 2720 23/08/2023 511882 Twin Sharing 1 1200.00 0.00 1200.00
307884 321979 12/08/2023 23/08/2023 Mast RUDRAA RAJESH SHINDE 2728 23/08/2023 511838 Triple Sharing 1 1200.00 0.00 1200.00
308052 323371 22/08/2023 29/08/2023 Mrs. ASHA GAJUREL 2721 23/08/2023 511933 Twin Sharing 2 2400.00 0.00 2400.00
308066 323647 23/08/2023 26/08/2023 Mrs. AMRUTA PATANKAR 2723 23/08/2023 511798 Twin Sharing 1 1200.00 0.00 1200.00
308067 323648 23/08/2023 28/08/2023 Mrs. SOPHIA MATHEW CHANDO 2724 23/08/2023 0 Single Ac Room 1 1200.00 0.00 1200.00
308069 323650 23/08/2023 27/08/2023 Mrs. KINJAL NAVAL BAWASKAR 2725 23/08/2023 511800 Twin Sharing 1 1200.00 0.00 1200.00
308075 323656 23/08/2023 26/08/2023 Mrs. MEENA PARASMAL PARMAR 2726 23/08/2023 511872 Twin Sharing 1 1200.00 0.00 1200.00
308080 323672 23/08/2023 24/08/2023 Mrs. TANVI KAUSTUBH INARKAR 2727 23/08/2023 511811 Twin Sharing 1 1200.00 0.00 1200.00
Date : 07/09/2023 Page 9 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00 4500.00
308076 323430 23/08/2023 28/08/2023 Female Baby Of RICHA TWIN 1 ASHISH 2730 23/08/2023 511901 NICU 1 4500.00 0.00 4500.00
AGARWAL
SERVICE CODE : 9600012 - RDP Process Charges 700.00 0.00 700.00
308059 323632 22/08/2023 25/08/2023 Mast KRISHIV SINGH 2722 23/08/2023 511855 Twin Sharing 1 700.00 0.00 700.00
308059 323632 22/08/2023 25/08/2023 Mast KRISHIV SINGH 2722 23/08/2023 511792 Twin Sharing 1 700.00 0.00 700.00
308059 323632 22/08/2023 25/08/2023 Mast KRISHIV SINGH 2722 23/08/2023 511792 Twin Sharing -1 -700.00 0.00 -700.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00 4230.00
308072 323562 23/08/2023 23/08/2023 Mrs. MEENAKSHI YASHESH PAJWANI 2729 23/08/2023 511797 Single Ac Room 1 4230.00 0.00 4230.00
SERVICE CODE : 9600016 - RDP Service Charges 400.00 0.00 400.00
308059 323632 22/08/2023 25/08/2023 Mast KRISHIV SINGH 2722 23/08/2023 511792 Twin Sharing -1 -400.00 0.00 -400.00
308059 323632 22/08/2023 25/08/2023 Mast KRISHIV SINGH 2722 23/08/2023 511855 Twin Sharing 1 400.00 0.00 400.00
308059 323632 22/08/2023 25/08/2023 Mast KRISHIV SINGH 2722 23/08/2023 511792 Twin Sharing 1 400.00 0.00 400.00

REV. DATE: 24/08/2023 17100.00 0.00 17100.00

CHARGE CODE: 96 - Blood Bank 17100.00 0.00 17100.00
SERVICE CODE : 9600010 - PRBC Service Charges 3600.00 0.00 3600.00
308096 319087 24/08/2023 29/08/2023 Mast DISHAN GAURAV NARANG 2736 24/08/2023 511857 Single Ac Room 1 1200.00 0.00 1200.00
308086 323090 24/08/2023 27/08/2023 Baba ARNAV KUMAR 2733 24/08/2023 0 Triple Sharing 1 1200.00 0.00 1200.00
308083 323319 23/08/2023 27/08/2023 Mrs. JIYA AKASH SUTHAR 2731 24/08/2023 511891 Twin Sharing 1 1200.00 0.00 1200.00
308066 323647 23/08/2023 26/08/2023 Mrs. AMRUTA PATANKAR 2723 23/08/2023 511798 Twin Sharing -1 -1200.00 0.00 -1200.00
308066 323647 23/08/2023 26/08/2023 Mrs. AMRUTA PATANKAR 2723 23/08/2023 511881 Twin Sharing 1 1200.00 0.00 1200.00
308069 323650 23/08/2023 27/08/2023 Mrs. KINJAL NAVAL BAWASKAR 2725 23/08/2023 511800 Twin Sharing -1 -1200.00 0.00 -1200.00
308069 323650 23/08/2023 27/08/2023 Mrs. KINJAL NAVAL BAWASKAR 2725 23/08/2023 511887 Twin Sharing 1 1200.00 0.00 1200.00
308080 323672 23/08/2023 24/08/2023 Mrs. TANVI KAUSTUBH INARKAR 2727 23/08/2023 511811 Twin Sharing -1 -1200.00 0.00 -1200.00
308080 323672 23/08/2023 24/08/2023 Mrs. TANVI KAUSTUBH INARKAR 2727 23/08/2023 511819 Twin Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 13500.00 0.00 13500.00
308092 321979 24/08/2023 24/08/2023 Mast RUDRAA RAJESH SHINDE 2732 24/08/2023 511815 Daycare 1 4500.00 0.00 4500.00
308086 323090 24/08/2023 27/08/2023 Baba ARNAV KUMAR 2735 24/08/2023 511893 Triple Sharing 1 4500.00 0.00 4500.00
308093 323720 24/08/2023 03/09/2023 Male Baby Of SULBHA CHAVAN 2734 24/08/2023 0 NICU 1 4500.00 0.00 4500.00

REV. DATE: 25/08/2023 3600.00 0.00 3600.00

CHARGE CODE: 96 - Blood Bank 3600.00 0.00 3600.00
SERVICE CODE : 9600010 - PRBC Service Charges 3600.00 0.00 3600.00
308116 299333 25/08/2023 27/08/2023 Mrs. NEHA JAIN 2739 25/08/2023 511931 Single Ac Room 1 1200.00 0.00 1200.00
308096 319087 24/08/2023 29/08/2023 Mast DISHAN GAURAV NARANG 2736 24/08/2023 511941 Single Ac Room 1 1200.00 0.00 1200.00
308096 319087 24/08/2023 29/08/2023 Mast DISHAN GAURAV NARANG 2736 24/08/2023 511857 Single Ac Room -1 -1200.00 0.00 -1200.00
308099 320908 24/08/2023 28/08/2023 Miss. AAYUSHI KHADYE 2737 25/08/2023 511897 Twin Sharing 1 1200.00 0.00 1200.00
308113 321103 25/08/2023 28/08/2023 Mrs. PRIYAL VISHAL CHOKSI 2738 25/08/2023 511876 Single Ac Room 1 1200.00 0.00 1200.00
308123 322359 25/08/2023 28/08/2023 Mrs. RUCHI SHAH 2740 25/08/2023 511906 Single Ac Room 1 1200.00 0.00 1200.00
308086 323090 24/08/2023 27/08/2023 Baba ARNAV KUMAR 2733 24/08/2023 0 Triple Sharing -1 -1200.00 0.00 -1200.00

REV. DATE: 26/08/2023 7830.00 0.00 7830.00

CHARGE CODE: 96 - Blood Bank 7830.00 0.00 7830.00
SERVICE CODE : 9600010 - PRBC Service Charges 3600.00 0.00 3600.00
308133 312803 26/08/2023 27/08/2023 Mr. SHAILESH SHANKAR CHOGALE 2743 26/08/2023 511889 Triple Sharing 1 1200.00 0.00 1200.00
308113 321103 25/08/2023 28/08/2023 Mrs. PRIYAL VISHAL CHOKSI 2738 25/08/2023 511876 Single Ac Room -1 -1200.00 0.00 -1200.00
308113 321103 25/08/2023 28/08/2023 Mrs. PRIYAL VISHAL CHOKSI 2738 25/08/2023 511900 Single Ac Room 1 1200.00 0.00 1200.00
Date : 07/09/2023 Page 10 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
308136 323440 26/08/2023 31/08/2023 Miss. JAILAXMI U DABHOLKAR 2744 26/08/2023 511984 Single Ac Room 1 1200.00 0.00 1200.00
308130 323821 26/08/2023 29/08/2023 Mrs. DEEPANWITA PATIL 2741 26/08/2023 512092 Single Ac Room 1 1200.00 0.00 1200.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00 4230.00
308133 312803 26/08/2023 27/08/2023 Mr. SHAILESH SHANKAR CHOGALE 2742 26/08/2023 511889 Triple Sharing 1 4230.00 0.00 4230.00

REV. DATE: 28/08/2023 9400.00 0.00 9400.00

CHARGE CODE: 96 - Blood Bank 9400.00 0.00 9400.00
SERVICE CODE : 9600010 - PRBC Service Charges 7200.00 0.00 7200.00
308147 267299 27/08/2023 30/08/2023 Mrs. SONAL GURUNATH AMUP 2749 28/08/2023 511955 Twin Sharing 1 1200.00 0.00 1200.00
308148 319239 27/08/2023 31/08/2023 Mrs. ASTHA VIRMANI NANGIA 2746 28/08/2023 511970 Single Ac Room 1 1200.00 0.00 1200.00
308135 323592 26/08/2023 30/08/2023 Mrs. BEAULAH SABITHA YARAM 2750 28/08/2023 511942 Single Ac Room 1 1200.00 0.00 1200.00
308154 323912 27/08/2023 30/08/2023 Miss. SHEETAL CHAHAR 2745 28/08/2023 511896 Single Ac Room -1 -1200.00 0.00 -1200.00
308154 323912 27/08/2023 30/08/2023 Miss. SHEETAL CHAHAR 2745 28/08/2023 512084 Single Ac Room 1 1200.00 0.00 1200.00
308154 323912 27/08/2023 30/08/2023 Miss. SHEETAL CHAHAR 2745 28/08/2023 511896 Single Ac Room 1 1200.00 0.00 1200.00
308165 323923 28/08/2023 01/09/2023 Miss. SRIVIDYA GOPAL 2748 28/08/2023 512005 Twin Sharing 2 2400.00 0.00 2400.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 0.00 0.00 0.00
307999 323469 19/08/2023 04/09/2023 Male Baby Of RAJSHREE PAWSE 2716 22/08/2023 511913 NICU -1 -4500.00 0.00 -4500.00
307999 323469 19/08/2023 04/09/2023 Male Baby Of RAJSHREE PAWSE 2716 22/08/2023 512067 NICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600012 - RDP Process Charges 1400.00 0.00 1400.00
308160 321979 28/08/2023 28/08/2023 Mast RUDRAA RAJESH SHINDE 2747 28/08/2023 0 Daycare 2 1400.00 0.00 1400.00
SERVICE CODE : 9600016 - RDP Service Charges 800.00 0.00 800.00
308160 321979 28/08/2023 28/08/2023 Mast RUDRAA RAJESH SHINDE 2747 28/08/2023 0 Daycare 2 800.00 0.00 800.00

REV. DATE: 29/08/2023 7830.00 0.00 7830.00

CHARGE CODE: 96 - Blood Bank 7830.00 0.00 7830.00
SERVICE CODE : 9600010 - PRBC Service Charges 4800.00 0.00 4800.00
308174 157790 28/08/2023 01/09/2023 Mrs. AKSHA SHAH 2752 29/08/2023 512010 Single Ac Room 1 1200.00 0.00 1200.00
308178 323978 29/08/2023 31/08/2023 Mrs. MOHINI KANTILAL BHANSALI 2754 29/08/2023 0 Triple Sharing 2 2400.00 0.00 2400.00
308182 323988 29/08/2023 01/09/2023 Mrs. GULSHAN PATEL 2753 29/08/2023 511945 Twin Sharing 1 1200.00 0.00 1200.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00 3030.00
308178 323978 29/08/2023 31/08/2023 Mrs. MOHINI KANTILAL BHANSALI 2751 29/08/2023 511978 Triple Sharing 1 3030.00 0.00 3030.00

REV. DATE: 30/08/2023 12330.00 0.00 12330.00

CHARGE CODE: 96 - Blood Bank 12330.00 0.00 12330.00
SERVICE CODE : 9600010 - PRBC Service Charges 4800.00 0.00 4800.00
308185 321656 29/08/2023 02/09/2023 Mrs. DEVAYANI NIYOGI 2758 30/08/2023 512031 Single Ac Room 1 1200.00 0.00 1200.00
308192 322327 30/08/2023 02/09/2023 Mrs. PRATIBHA DHOLE 2760 30/08/2023 512111 Single Ac Room 1 1200.00 0.00 1200.00
308190 323083 30/08/2023 01/09/2023 Mrs. SHACHI MODY 2755 30/08/2023 512006 Twin Sharing 1 1200.00 0.00 1200.00
308178 323978 29/08/2023 31/08/2023 Mrs. MOHINI KANTILAL BHANSALI 2754 29/08/2023 0 Triple Sharing -2 -2400.00 0.00 -2400.00
308178 323978 29/08/2023 31/08/2023 Mrs. MOHINI KANTILAL BHANSALI 2761 30/08/2023 511978 Triple Sharing 1 1200.00 0.00 1200.00
308182 323988 29/08/2023 01/09/2023 Mrs. GULSHAN PATEL 2753 29/08/2023 511945 Twin Sharing -1 -1200.00 0.00 -1200.00
308182 323988 29/08/2023 01/09/2023 Mrs. GULSHAN PATEL 2753 29/08/2023 512003 Twin Sharing 1 1200.00 0.00 1200.00
308189 324008 29/08/2023 01/09/2023 Mrs. PRITI DEVEN SHETH 2757 30/08/2023 511947 Twin Sharing 1 1200.00 0.00 1200.00
308189 324008 29/08/2023 01/09/2023 Mrs. PRITI DEVEN SHETH 2757 30/08/2023 511947 Twin Sharing -1 -1200.00 0.00 -1200.00
308189 324008 29/08/2023 01/09/2023 Mrs. PRITI DEVEN SHETH 2757 30/08/2023 511998 Twin Sharing 1 1200.00 0.00 1200.00
308193 324014 30/08/2023 01/09/2023 Mrs. MEERA MOHABE 2759 30/08/2023 512099 Twin Sharing 1 1200.00 0.00 1200.00
Date : 07/09/2023 Page 11 of 11
Time : 08:48 AM In Patient Charge Wise Service Wise Details User : ARUNH
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/08/2023 To 31/08/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt Net Amt
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00 4500.00
308196 322720 30/08/2023 31/08/2023 Female Baby Of SANGEETA LODHA JAIN 2762 30/08/2023 511971 NICU 1 4500.00 0.00 4500.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00 3030.00
308178 323978 29/08/2023 31/08/2023 Mrs. MOHINI KANTILAL BHANSALI 2756 30/08/2023 511978 Triple Sharing 1 3030.00 0.00 3030.00

REV. DATE: 31/08/2023 4800.00 0.00 4800.00

CHARGE CODE: 96 - Blood Bank 4800.00 0.00 4800.00
SERVICE CODE : 9600010 - PRBC Service Charges 4800.00 0.00 4800.00
308217 318383 31/08/2023 03/09/2023 Mrs. ISHA MOHTA 2764 31/08/2023 512052 Suite Marigold 1 1200.00 0.00 1200.00
308217 318383 31/08/2023 03/09/2023 Mrs. ISHA MOHTA 2765 31/08/2023 512052 Suite Marigold 1 1200.00 0.00 1200.00
308148 319239 27/08/2023 31/08/2023 Mrs. ASTHA VIRMANI NANGIA 2746 28/08/2023 511970 Single Ac Room -1 -1200.00 0.00 -1200.00
308148 319239 27/08/2023 31/08/2023 Mrs. ASTHA VIRMANI NANGIA 2746 28/08/2023 511976 Single Ac Room 1 1200.00 0.00 1200.00
308216 320989 31/08/2023 04/09/2023 Mrs. AMRIN AGVAN 2766 31/08/2023 512083 Single Ac Room 1 1200.00 0.00 1200.00
308214 324073 31/08/2023 03/09/2023 Mrs. PREETI MEHROTRA 2763 31/08/2023 512038 Single Ac Room 1 1200.00 0.00 1200.00

Grand Total : 367570.00 0.00 367570.00

-End Of Report-