Bill of Supply / Tax Invoice

Name Mr.AVINASH KUMAR Bill DIVYB/21-22/00003095

Age/Gender 33 Y 9 M 14 D /Male Visit/Reg Date 01-Sep-2021 09:21AM
Contact No 8275372115 Refered By Dr.SELF
Address Wagholi,Pune Visit No DIVYOPV10356
UHID DIVY.0000001585 Center PCC IVY ESTATE PUNE
Home Collection No Center Ph. No 7030457555
Center Address Shop No-2, Aarambha Commerical Complex,
Ivy Estate Road, Wagholi, Pune-4122076

# Service Code Service Name SAC Code Rate Total

1 BI047 BI047~GLUCOSE, FASTING 999316 80 80
2 BI048 BI048~GLUCOSE, POST PRANDIAL (PP), 2 HOURS (POST MEAL) 999316 80 80
Bill Amount : 160
Settlement Payment Receipt No Mode Amount
Net Bill Amount : 160
Settlement 01-09-2021 DIVYR/21-22/00003096 Cash 160
Total Paid Amount : 160
Received with thanks : One Hundred And Sixty Only Authorized Signature :
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01-Sep-2021 09:21 AM Page 1 of 1