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    Statement

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    Fahad Ahmed
    Mount Adora Hospital provided healthcare services to Md Muhibur Rahman from September 29th to November 2nd totaling 1,338,274 Taka (approximately $13,382). The statement notes that Mr. Rahman does not have insurance and provides contact information for the billing office. It also directs patients to the reverse side for payment and financial assistance options.

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    Statement

    Uploaded by

    Fahad Ahmed
    4 views1 page
    Mount Adora Hospital provided healthcare services to Md Muhibur Rahman from September 29th to November 2nd totaling 1,338,274 Taka (approximately $13,382). The statement notes that Mr. Rahman does not have insurance and provides contact information for the billing office. It also directs patients to the reverse side for payment and financial assistance options.

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    Mount Adora Hospital provided healthcare services to Md Muhibur Rahman from September 29th to November 2nd totaling 1,338,274 Taka (approximately $13,382). The statement notes that Mr. Rahman does not have insurance and provides contact information for the billing office. It also directs patients to the reverse side for payment and financial assistance options.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as pdf or txt
    4 views1 page

    Statement

    Uploaded by

    Fahad Ahmed
    Mount Adora Hospital provided healthcare services to Md Muhibur Rahman from September 29th to November 2nd totaling 1,338,274 Taka (approximately $13,382). The statement notes that Mr. Rahman does not have insurance and provides contact information for the billing office. It also directs patients to the reverse side for payment and financial assistance options.

    Copyright:

    © All Rights Reserved
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    Akhalia, Sylhet, Bangladesh.

    Mobile- +880 1798-334369 Email: www.mountadora.sylhet33@gmail.com

    STATEMENT DATE
    03 November 2023
    STATEMENT NUMBER
    AKC9FDZ77R

    Thank you for selecting Mount Adora Hospital for your health care needs. Our records you indicate you do
    not have insurance. If you have insurance, please contact our office to provide this information. Please see
    the revers side of this statement for additional on payment methods and financial assistance option.

    ➢ SUMMARY OF PATIENT SERVICES ➢ PATIENT DETAILS


    Cn Diagnostic Rad 7800.00 Patient Name Md Muhibur Rahman
    CS Echocardiography 10853.00 Address Kalaiura, Lakhaura, Sylhet.
    CN EKG 5300.00 Gender Male
    CS EKG 5553.00 Age 51 Years
    CN Emergency Dept 11100.00 Service Date(s) 29 September to 2 November
    CS Lab 155408.00
    CN Lab 8700.00
    CS Pharmacy 80060.00
    CN Pharmacy 86000.00
    CS Respiratory Care 58000.00
    Cox Emergency Phys 6500.00
    Special Care 200000.00
    CS Cardiovas Cath 15000.00
    Intensive Care Room 255000.00
    CS Central Supply 35000.00
    Others 398000.00
    Total: 1338,274.00

    In Words- Thirteen lakh thirty-eight thousand two hundred seventy-four Taka.

    Received by Abu Rayhan

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