Date/Time : 2079/1 1/30(2023/03/14) / 07:58:10 ORTHOPEDICS DEPT. Hospital No. - 79034357 Rela: AT Name - MS. BHAGIRATHA BASNET Charge : 200.00 Age/Sex : 70 ¥rs 11 Mth/F User - RENUKA Address > Urlabari-1, MORANG Scheme > HEALTH INSURANCE NSHI Code : 084284266 Claim Code : 108755226MADAN BHANDARI HOSPITAL & TRAUMA CENTER Mangalbare, Urlabari,Morang Print Date : 2079/12/06 From: 2079/11/30 17:58:21 To: 2079/11/30 Bill Summary PR No: 79034357 AgelSex: 71/F Patient Name: BHAGIRATHA BASNET Bima No.: 094204266 Address: Urlabari-1 Claim Code 108755226 Bill Date Bill No Description Amount Pay Type 2079/11/30 8 CR80-0097584 OPD HOSPITAL 200 CREDIT 20794130 CRF9/80-0097890 X-RAY DOUBLE VIEW (HANDIFOOT) 450 CREDIT 207911/30 CRPS/80-0098054 FRACTURE REDUCTION POP CAST 1200 CREDIT MINOR/SLAB Total Received Amount: 1850 Total Deposit Amount : 0 Total Deposit Refund : 0 inWords: One Thousand Eight Hundred Fifty Only Authorize Signature : Name DesignationOrthopedics Dept. Queue No. :3 Date/Time 2079/4 1/30 BS x 07:58 Room No. : 6 Hospital No 79034357 Patient Name Bhagiratha Basnet Age/Sex 70 Yrs 11 Mthye Bic ae. 100009 Address . Urlabari-7, MORANG Phone No 0 INSURANCE ser RENUKA Claim Code 108755226 Charg . iS Bima No 284284266 Aaerary. seta, Scheme , &: Rs. 29 “ACTH Numan ll Ltn = trawiea . than o kt Ve oy eho AP Se — Gc mp a qth bate cor pr VidUce’ CK bow ae Gl bow Batsat Freezer aT Be wadt tar i a Orthopedics Dept. Room No. : Hospitay No 6 79034357 / a Mm ft in tl rim i Glieue Noe Date/Time 2079/4 1/30 BS 07:58 Bic.=Rg 100000 | beige > Patient Name S. Bhagirg ‘atha Basnet Age/Sex 70 Yrs 11 Mthye | Address Urlabari- de MORANG Phone No. 0 ser RENUKA Claim Code 108755545 Bima No 984284266 Fada, Sata, awe Scheme BEALTHINSURANop ,