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Mobile No :, . Email :minthospitals@gmail.

com
PAN NO:AAKCM6077A / TAN NO:CHEM17453C / CIN NO:U74999TN2016PTC112873

Patient Bill
Patient ID : 190900139 Address : 69,1 ST AVE , Admit Date : 24/09/2020 11:30AM
ADAYAR,CHENNAI , 600020
Patient Name : Mr.SUNDARESAN Dis.Date :
TAMIL NADU,INDIA
Age/Sex : 75/Male Ward Type : ICU

Mobile / Phone No : 7338777333 / Ward No :1

Consultant Name : MH,HOSPITAL IP Bill No : IP/136/2020-21

Payment Type : Cash

Patient ID : 190900139 Patient Name : Mr.SUNDARESAN Admit Date : 24/09/2020

Date Service Amount


GENERAL
26/09/2020 PHARMACY CHARGES 395.00
Day Total 395.00
27/09/2020 PHARMACY CHARGES 59.00
27/09/2020 PHARMACY CHARGES 213.00
27/09/2020 PHARMACY CHARGES 475.00
Day Total 747.00
29/09/2020 PHARMACY CHARGES 1425.40
Day Total 1425.40
30/09/2020 PHARMACY CHARGES 236.00
30/09/2020 PHARMACY CHARGES 671.00
Day Total 907.00
03/10/2020 PHARMACY CHARGES 975.80
Day Total 975.80
04/10/2020 PHARMACY CHARGES 230.00
Day Total 230.00

GENERAL Total : 4680.20

SERVICES
24/09/2020 AMBULANCE CHARGE 6500.00
04/10/2020 AMBULANCE CHARGE 2500.00

SERVICES Total : 9000.00

TREATMENT CHARGES
24/09/2020 CT CHEST 7500.00
25/09/2020 OXYGEN CHARGES 2500.00
26/09/2020 OXYGEN CHARGES 2500.00
27/09/2020 OXYGEN CHARGES 2500.00
28/09/2020 OXYGEN CHARGES 2500.00
29/09/2020 OXYGEN CHARGES 2500.00
Patient ID : 190900139 Patient Name : Mr.SUNDARESAN Admit Date : 24/09/2020

Date Service Amount

30/09/2020 OXYGEN CHARGES 2500.00

TREATMENT CHARGES Total : 22500.00

LAB
24/09/2020 PRO BNP 4000.00
24/09/2020 I L6 4000.00
24/09/2020 D - DIMER 1750.00
24/09/2020 LDH - SERUM 450.00
24/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
24/09/2020 RENAL FUNCTION TEST ( RFT ) 400.00
24/09/2020 LIVER FUNCTION TEST ( LFT ) 750.00
24/09/2020 PROTHROMBIN TIME ( PT ) 350.00
24/09/2020 HBA1C 500.00
24/09/2020 ACTIVATED PARTIAL THROMBOPLASTIN ( APTT ) 350.00
24/09/2020 CRP (C.REACTIVE PROTEIN) 350.00
24/09/2020 QBC MP 200.00
24/09/2020 DENGUE ANTIBODY 900.00
24/09/2020 SCRUB TYPHUS IGM 1500.00
24/09/2020 WIDAL 200.00
Day Total 16200.00
25/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
25/09/2020 ELECTROLYTES 450.00
25/09/2020 FREE THYROID PROFILE 850.00
Day Total 1800.00
26/09/2020 PROTHROMBIN TIME ( PT ) 350.00
26/09/2020 ACTIVATED PARTIAL THROMBOPLASTIN ( APTT ) 350.00
26/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
26/09/2020 ELECTROLYTES 450.00
26/09/2020 URINE CULTURE 400.00
26/09/2020 BLOOD CULTURE / SENSITIVITY 900.00
Day Total 2950.00
27/09/2020 AMMONIA 800.00
27/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
27/09/2020 LIVER FUNCTION TEST ( LFT ) 750.00
27/09/2020 ELECTROLYTES 450.00
27/09/2020 RENAL FUNCTION TEST ( RFT ) 400.00
Day Total 2900.00
28/09/2020 RENAL FUNCTION TEST ( RFT ) 400.00
28/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
Day Total 900.00
29/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
29/09/2020 LIVER FUNCTION TEST ( LFT ) 750.00
Day Total 1250.00
30/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
Patient ID : 190900139 Patient Name : Mr.SUNDARESAN Admit Date : 24/09/2020

Date Service Amount

30/09/2020 RENAL FUNCTION TEST ( RFT ) 400.00


30/09/2020 CORD BLOOD GROUPING & RH TYPING 150.00
30/09/2020 COVID 19 (PCR) 3000.00
Day Total 4050.00
01/10/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
01/10/2020 RENAL FUNCTION TEST ( RFT ) 400.00
01/10/2020 ARTERIAL BLOOD GAS 750.00
01/10/2020 ELECTROLYTES 450.00
01/10/2020 PRO BNP 4000.00
01/10/2020 D - DIMER 1750.00
01/10/2020 I L6 4000.00
01/10/2020 IRON 450.00
01/10/2020 FERITTIN 750.00
01/10/2020 TIBC-TOTAL PROTEIN BINDING CAPACITY 350.00
01/10/2020 SR.DIGOXCIN 2000.00
Day Total 15400.00
02/10/2020 ELECTROLYTES 450.00
02/10/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
02/10/2020 RENAL FUNCTION TEST ( RFT ) 400.00
Day Total 1350.00
03/10/2020 PRO BNP 4000.00
03/10/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
03/10/2020 ELECTROLYTES 450.00
03/10/2020 RENAL FUNCTION TEST ( RFT ) 400.00
03/10/2020 FERITTIN 750.00
03/10/2020 D - DIMER 1750.00
03/10/2020 I L6 4000.00
03/10/2020 COVID ANTIBODY IGG 1200.00
03/10/2020 COVID 19 (PCR) 3000.00
03/10/2020 MEGNICIUM ( ME+ ) 800.00
Day Total 16850.00
04/10/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
04/10/2020 RENAL FUNCTION TEST ( RFT ) 400.00
04/10/2020 ELECTROLYTES 450.00
Day Total 1350.00

LAB Total : 65000.00

XRAY
24/09/2020 X RAY CHEST AP VIEW 400.00
Day Total 400.00

XRAY Total : 400.00

ULTRASOUND
Patient ID : 190900139 Patient Name : Mr.SUNDARESAN Admit Date : 24/09/2020

Date Service Amount

25/09/2020 ECHO 2500.00


Day Total 2500.00

ULTRASOUND Total : 2500.00

IP CONSULTATION
24/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 5000.00
25/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
26/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
27/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
28/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
29/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
30/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
01/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
02/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 5000.00
02/10/2020 Dr. PRADEEP NAIR CARDIOLOGIST 2500.00
03/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
04/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00

IP CONSULTATION Total : 102500.00

PHARMACY
24/09/2020 PHARMACY CHARGES 4759.00
25/09/2020 PHARMACY CHARGES 20138.00
26/09/2020 PHARMACY CHARGES 17243.00
27/09/2020 PHARMACY CHARGES 8825.00
28/09/2020 PHARMACY CHARGES 16591.00
29/09/2020 PHARMACY CHARGES 7502.00
30/09/2020 PHARMACY CHARGES 8126.00
01/10/2020 PHARMACY CHARGES 4442.00
02/10/2020 PHARMACY CHARGES 5060.00
03/10/2020 PHARMACY CHARGES 4699.00
04/10/2020 PHARMACY CHARGES 12411.00

PHARMACY Total : 109796.00

Total : 316376.20

Discount : 0.00

Rounded Off : -0.20

Total : 316376.00
Amount to be Received : 316376.00

Bill Prepared by : SELVI

Bill Checked by :
Authorized Signatory

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