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INPATIENT DETAILED BILL


Patient Name: Baby HARSHITHA Bill No: BL016363
Age/Sex: 21 M / F Bill Date: 16-05-2018
Department: Paediatric Admission Date and 15-05-2018 20:11
Time:
UHID No.: SRH00056972 Discharge Date and
Time:
Inpatient No: SRH-IP-00009411 Ward: FEMALE WARD
Consultant: Dr. Rajesham G Bed Type: GENERAL

Sl.No. Date Description Rate Qty Amount


1 IP Doctor Visit
  16-05-2018 Dr. Rajesham G 600.00 2 1,200.00
 Sub Total: 1,200.00
2 Bed Charge
  15-05-2018 GENERAL1  800.00 1 800.00
3 Nurse Charge
  15-05-2018 GENERAL1  300.00 1 300.00
4 Duty Doctor Charge
  15-05-2018 GENERAL1  300.00 1 300.00
5 Professional Charge
  15-05-2018 GENERAL1  100.00 1 100.00
 Sub Total: 1,500.00
6 Lab Tests
  16-05-2018 PLATELET COUNT 150.00 1 150.00
 Sub Total: 150.00
7 Service
  16-05-2018 IV EP/IP 100.00 1 100.00
  16-05-2018 IV Set & Canula 250.00 1 250.00
  16-05-2018 REGISTRATION FEE 100.00 1 100.00
  16-05-2018 NEBULIZATION CHARGES 50.00 2 100.00
 Sub Total: 550.00
 
Bill Amount: 3,400.00

Bill Summary
  Bill Amount:   3,400.00
  Total Amount:   3,400.00
Patient share:   3,400.00
  Patient Payments:   3,400.00
Net Payable 0.00
 

Payments Receipt No Mode Card Type Bank Reference No Amount


Settlement
16-05-2018 RC121055 Cash 3,400.00
 
Net Payments: 3,400.00
 
Generated By : Saraswathi

This is a computer generated bill and signature is not required.

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