This document is a payment receipt from Medcis Pathlabs for a Wellness II profile test costing Rs. 1500. It provides details of the patient such as name, age, gender, sample collection date and contact information. It also lists the test details, total amount paid and includes signatures from the authorized signatory and collection center details.
This document is a payment receipt from Medcis Pathlabs for a Wellness II profile test costing Rs. 1500. It provides details of the patient such as name, age, gender, sample collection date and contact information. It also lists the test details, total amount paid and includes signatures from the authorized signatory and collection center details.
This document is a payment receipt from Medcis Pathlabs for a Wellness II profile test costing Rs. 1500. It provides details of the patient such as name, age, gender, sample collection date and contact information. It also lists the test details, total amount paid and includes signatures from the authorized signatory and collection center details.
Name: MALINA BISWAS Anand Nagar, Near Asish Gardens, New Bowenpally CLINICAL BIOCHEMISTRY Secunderabad - 11 Patient Name Email: info@medcislabs.com; URL: www.medcislabs.com Age/Gender Sample Type PAYMENT RECEIPT MEDID:3692052 Sample ID DATE: 08-08-2018 Ref. Doctor Referred By:DR PABITRA MITRA Age/Gender: 50 YR/FEMALE ABHIJIT SENGUPTA Sample Collection Date: 08-08-2018 Age/Gender DR AMITAVASATIN SAHASEN NAGAR, NEW Mobile No.: Sample Address:Type Sample ID BARRACKPUR,KOLKATA - 700131 Mail ID: Sr.Doctor Ref. No. Test Details Amount (In Rs) DIPTI01CHATTERJEE WELLNESS II PROFILE 1500.00 02 03 04 05 06 Rs (In Words): ONE THOUSAND AND FIVE HUNDRED ONLY Total Amt: 1500.00