Date : 07/06/2023 Pa

Time : 07:09 PM User

In Patient Charge Wise Service Wise Details
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/05/2023 To 31/05/2023
IP No UHID No. Adm. Date Dschg. Date Patient Name Vch No Vch Date Bill No Patient Class Units Amount Sharer Amt
REV. DATE: 1/05/2023 3600.00 0.00
CHARGE CODE: 96 - Blood Bank 3600.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 3600.00 0.00
306178 315663 29/04/2023 01/05/2023 Mrs. SONALI ABHISHEK DAWLE 2102 29/04/2023 509339 Triple Sharing -1 -1200.00 0.00
306178 315663 29/04/2023 01/05/2023 Mrs. SONALI ABHISHEK DAWLE 2102 29/04/2023 509340 Triple Sharing 1 1200.00 0.00
306194 314241 30/04/2023 04/05/2023 Mrs. SOPHIE JEANNE CHAPPUIS 2106 01/05/2023 509352 Suite Lotus 1 1200.00 0.00
306199 318556 01/05/2023 03/05/2023 Mast HRIDHAN HARSHAL KAMBLE 2105 01/05/2023 509360 Twin Sharing 1 1200.00 0.00
306210 6427 01/05/2023 04/05/2023 Mrs. NIHARIKA CHATURVEDI 2107 01/05/2023 509355 Single Ac Room 1 1200.00 0.00

REV. DATE: 2/05/2023 8100.00 0.00

CHARGE CODE: 96 - Blood Bank 8100.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 3600.00 0.00
306194 314241 30/04/2023 04/05/2023 Mrs. SOPHIE JEANNE CHAPPUIS 2106 01/05/2023 509352 Suite Lotus -1 -1200.00 0.00
306194 314241 30/04/2023 04/05/2023 Mrs. SOPHIE JEANNE CHAPPUIS 2106 01/05/2023 509377 Suite Lotus 1 1200.00 0.00
306210 6427 01/05/2023 04/05/2023 Mrs. NIHARIKA CHATURVEDI 2107 01/05/2023 509355 Single Ac Room -1 -1200.00 0.00
306210 6427 01/05/2023 04/05/2023 Mrs. NIHARIKA CHATURVEDI 2107 01/05/2023 509378 Single Ac Room 1 1200.00 0.00
306215 162499 02/05/2023 05/05/2023 Mrs. AKRITI KHANDELWAL 2109 02/05/2023 509384 Single Ac Room 1 1200.00 0.00
306223 314727 02/05/2023 05/05/2023 Mrs. VANDANA ROHAN VEDPATHAK 2110 02/05/2023 509382 Single Ac Room 1 1200.00 0.00
306226 318660 02/05/2023 05/05/2023 Mrs. MAMTA BORAR 2111 02/05/2023 509402 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00
306184 314293 29/04/2023 09/05/2023 Male Baby Of RASHMI . . 2108 02/05/2023 509477 NICU 1 4500.00 0.00

REV. DATE: 3/05/2023 13200.00 0.00

CHARGE CODE: 96 - Blood Bank 13200.00 0.00
SERVICE CODE : 9600005 - FFP Service Charges 400.00 0.00
306232 303478 03/05/2023 09/05/2023 Mast KAVISH VISHAL NAIK 2117 03/05/2023 509495 Twin Sharing 2 400.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 8400.00 0.00
306231 317035 02/05/2023 06/05/2023 Mrs. SHAMBHAVI TRIPATHI 2112 03/05/2023 509438 Single Ac Room 1 1200.00 0.00
306232 303478 03/05/2023 09/05/2023 Mast KAVISH VISHAL NAIK 2117 03/05/2023 509495 Twin Sharing 2 2400.00 0.00
306234 310222 03/05/2023 08/05/2023 Mrs. PRAJAKTA JAIN 2113 03/05/2023 509458 Single Ac Room 1 1200.00 0.00
306237 51178 03/05/2023 06/05/2023 Mrs. LEENA DIGHE 2115 03/05/2023 509422 Twin Sharing 1 1200.00 0.00
306240 318685 03/05/2023 05/05/2023 Mrs. MAUSAM KESARWANI 2116 03/05/2023 509413 Single Ac Room 1 1200.00 0.00
306244 305390 03/05/2023 09/05/2023 Mrs. ANASUYA PREMJI SHETA 2118 03/05/2023 509385 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600012 - RDP Process Charges 2800.00 0.00
306232 303478 03/05/2023 09/05/2023 Mast KAVISH VISHAL NAIK 2114 03/05/2023 509495 Twin Sharing 4 2800.00 0.00
SERVICE CODE : 9600016 - RDP Service Charges 1600.00 0.00
306232 303478 03/05/2023 09/05/2023 Mast KAVISH VISHAL NAIK 2114 03/05/2023 509495 Twin Sharing 4 1600.00 0.00

REV. DATE: 4/05/2023 14730.00 0.00

CHARGE CODE: 96 - Blood Bank 14730.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 7200.00 0.00
306215 162499 02/05/2023 05/05/2023 Mrs. AKRITI KHANDELWAL 2109 02/05/2023 509384 Single Ac Room -1 -1200.00 0.00
306215 162499 02/05/2023 05/05/2023 Mrs. AKRITI KHANDELWAL 2109 02/05/2023 509390 Single Ac Room 1 1200.00 0.00
306223 314727 02/05/2023 05/05/2023 Mrs. VANDANA ROHAN VEDPATHAK 2110 02/05/2023 509382 Single Ac Room -1 -1200.00 0.00
306223 314727 02/05/2023 05/05/2023 Mrs. VANDANA ROHAN VEDPATHAK 2110 02/05/2023 509394 Single Ac Room 1 1200.00 0.00
306244 305390 03/05/2023 09/05/2023 Mrs. ANASUYA PREMJI SHETA 2118 03/05/2023 509385 Single Ac Room -1 -1200.00 0.00
306244 305390 03/05/2023 09/05/2023 Mrs. ANASUYA PREMJI SHETA 2118 03/05/2023 509490 Single Ac Room 1 1200.00 0.00
306244 305390 03/05/2023 09/05/2023 Mrs. ANASUYA PREMJI SHETA 2125 04/05/2023 509490 Single Ac Room 2 2400.00 0.00
306248 118319 03/05/2023 08/05/2023 Mrs. MEENAKSHI MAHENDRA 2121 04/05/2023 509462 Single Ac Room 1 1200.00 0.00
306249 295009 04/05/2023 06/05/2023 Mast SWARAJ SUMIT SUGADARE 2120 04/05/2023 509430 Triple Sharing 1 1200.00 0.00
306251 318637 04/05/2023 07/05/2023 Mrs. NEENA COLIN CARDOZO 2123 04/05/2023 509448 Single Ac Room 1 1200.00 0.00
Date : 07/06/2023 Pa

Time : 07:09 PM User

In Patient Charge Wise Service Wise Details
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/05/2023 To 31/05/2023
306253 48043 04/05/2023 07/05/2023 Dr. (Mrs.) SANA ZAINAB PATEL 2124 04/05/2023 509451 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00
306245 318730 03/05/2023 13/05/2023 Female Baby Of GULZAR FATIMA SHAIKH 2122 04/05/2023 0 NICU 1 4500.00 0.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00
306232 303478 03/05/2023 09/05/2023 Mast KAVISH VISHAL NAIK 2119 04/05/2023 509495 Twin Sharing 1 3030.00 0.00

REV. DATE: 5/05/2023 10860.00 0.00

CHARGE CODE: 96 - Blood Bank 10860.00 0.00
SERVICE CODE : 9600006 - Irradiation 1200.00 0.00
306275 291023 05/05/2023 06/05/2023 Miss. NIRVI SANTOSH KUSHE 2128 05/05/2023 509434 Economy 1 1200.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00
306261 318766 04/05/2023 08/05/2023 Dr. (Mrs.) ZENY VYAS 2127 05/05/2023 509457 Suite Lotus 1 1200.00 0.00
306274 318792 05/05/2023 08/05/2023 Mrs. SHWETA GOKHARU 2129 05/05/2023 509464 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00
306275 291023 05/05/2023 06/05/2023 Miss. NIRVI SANTOSH KUSHE 2128 05/05/2023 509434 Economy 1 4230.00 0.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00
306250 318733 04/05/2023 10/05/2023 Mast TANAY SWAPNIL BHOKRE 2126 05/05/2023 509510 Twin Sharing 1 3030.00 0.00

REV. DATE: 6/05/2023 16860.00 0.00

CHARGE CODE: 96 - Blood Bank 16860.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 9600.00 0.00
306271 280637 05/05/2023 14/05/2023 Mrs. MANISHA CHANDRAKANT KANITKAR 2133 06/05/2023 509606 Twin Sharing 4 4800.00 0.00
306281 315388 05/05/2023 10/05/2023 Mrs. KHUSHBOO TEJAS MEHTA 2130 06/05/2023 509502 Single Ac Room 1 1200.00 0.00
306283 318812 06/05/2023 08/05/2023 Mrs. RAJESHWARI RAJESH NADKAR 2131 06/05/2023 509471 Economy 1 1200.00 0.00
306284 30144 06/05/2023 10/05/2023 Mrs. DISHITA JATIN BHATIA 2134 06/05/2023 509496 Single Ac Room 1 1200.00 0.00
306293 316883 06/05/2023 11/05/2023 Mrs. SHABANA FARHAN MEMON 2136 06/05/2023 509533 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00
306282 318811 06/05/2023 13/05/2023 Mast AAYUSH TEJAS SHAH 2135 06/05/2023 509561 Single Ac Room 1 4230.00 0.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00
306287 313129 06/05/2023 06/05/2023 Mr. WALI MOHD KHAN 2132 06/05/2023 509445 Daycare 1 3030.00 0.00

REV. DATE: 7/05/2023 6060.00 0.00

CHARGE CODE: 96 - Blood Bank 6060.00 0.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 6060.00 0.00
306271 280637 05/05/2023 14/05/2023 Mrs. MANISHA CHANDRAKANT KANITKAR 2137 07/05/2023 509606 Twin Sharing 1 3030.00 0.00
306271 280637 05/05/2023 14/05/2023 Mrs. MANISHA CHANDRAKANT KANITKAR 2138 07/05/2023 509606 Twin Sharing 1 3030.00 0.00

REV. DATE: 8/05/2023 4600.00 0.00

CHARGE CODE: 96 - Blood Bank 4600.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00
306305 318321 07/05/2023 12/05/2023 Mrs. SHOBHA ASRANI 2140 08/05/2023 509538 Twin Sharing 1 1200.00 0.00
306313 318332 08/05/2023 11/05/2023 Mrs. KOMAL GARG 2141 08/05/2023 509522 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600012 - RDP Process Charges 1400.00 0.00
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509482 Triple Sharing 2 1400.00 0.00
SERVICE CODE : 9600016 - RDP Service Charges 800.00 0.00
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509482 Triple Sharing 2 800.00 0.00

REV. DATE: 9/05/2023 23820.00 0.00

CHARGE CODE: 96 - Blood Bank 23820.00 0.00
Date : 07/06/2023 Pa

Time : 07:09 PM User

In Patient Charge Wise Service Wise Details
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/05/2023 To 31/05/2023
SERVICE CODE : 9600010 - PRBC Service Charges 6000.00 0.00
306307 317294 07/05/2023 13/05/2023 Mrs. ARCHANA GUPTA 2149 09/05/2023 509567 Single Ac Room 1 1200.00 0.00
306315 318908 08/05/2023 11/05/2023 Mrs. RUKSANA SAYED 2142 09/05/2023 509519 Triple Sharing 1 1200.00 0.00
306316 318909 08/05/2023 12/05/2023 Mrs. MANJULA TREHAN 2148 09/05/2023 509553 Suite Lotus 1 1200.00 0.00
306320 318920 08/05/2023 11/05/2023 Mrs. DEEPA SUBHASH SUVARNA 2147 09/05/2023 509515 Single Ac Room 1 1200.00 0.00
306334 250448 09/05/2023 13/05/2023 Mrs. SANSKRUTI PATIL 2150 09/05/2023 509584 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00
306335 317353 09/05/2023 11/05/2023 Male Baby Of KANIKA KHANNA 2151 09/05/2023 509528 NICU 1 4500.00 0.00
SERVICE CODE : 9600012 - RDP Process Charges 0.00 0.00
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509482 Triple Sharing -2 -1400.00 0.00
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509517 Triple Sharing 2 1400.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00
306326 318316 09/05/2023 09/05/2023 Baby YUKTI SAJNANI 2145 09/05/2023 509492 Economy 1 4230.00 0.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 9090.00 0.00
306310 54446 08/05/2023 16/05/2023 Mrs. KIRANDEEP KAUR SOHAL 2143 09/05/2023 509629 Twin Sharing 1 3030.00 0.00
306310 54446 08/05/2023 16/05/2023 Mrs. KIRANDEEP KAUR SOHAL 2144 09/05/2023 509629 Twin Sharing 1 3030.00 0.00
306310 54446 08/05/2023 16/05/2023 Mrs. KIRANDEEP KAUR SOHAL 2146 09/05/2023 509629 Twin Sharing 1 3030.00 0.00
SERVICE CODE : 9600016 - RDP Service Charges 0.00 0.00
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509482 Triple Sharing -2 -800.00 0.00
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509517 Triple Sharing 2 800.00 0.00

REV. DATE: 10/05/2023 27800.00 0.00

CHARGE CODE: 96 - Blood Bank 27800.00 0.00
SERVICE CODE : 9600004 - FFP Process Charges 1400.00 0.00
306229 318669 02/05/2023 12/05/2023 Female Baby Of MAMTA TWIN 2 BORAR 2153 10/05/2023 0 NICU 1 700.00 0.00
306229 318669 02/05/2023 12/05/2023 Female Baby Of MAMTA TWIN 2 BORAR 2156 10/05/2023 0 NICU 1 700.00 0.00
SERVICE CODE : 9600005 - FFP Service Charges 400.00 0.00
306339 318957 09/05/2023 13/05/2023 Mast SIDDIQUI IMRAN HALARI 2159 10/05/2023 509621 PICU 2 400.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 3600.00 0.00
306320 318920 08/05/2023 11/05/2023 Mrs. DEEPA SUBHASH SUVARNA 2147 09/05/2023 509515 Single Ac Room -1 -1200.00 0.00
306320 318920 08/05/2023 11/05/2023 Mrs. DEEPA SUBHASH SUVARNA 2147 09/05/2023 509527 Single Ac Room 1 1200.00 0.00
306339 318957 09/05/2023 13/05/2023 Mast SIDDIQUI IMRAN HALARI 2159 10/05/2023 509621 PICU 2 2400.00 0.00
306348 316477 10/05/2023 13/05/2023 Mrs. RUCHI JAIN 2160 10/05/2023 509577 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 18000.00 0.00
305664 316856 27/03/2023 06/04/2023 Male Baby Of KHUSHBU SINGH 2158 10/05/2023 0 NICU 1 4500.00 0.00
306229 318669 02/05/2023 12/05/2023 Female Baby Of MAMTA TWIN 2 BORAR 2154 10/05/2023 0 NICU 1 4500.00 0.00
306229 318669 02/05/2023 12/05/2023 Female Baby Of MAMTA TWIN 2 BORAR 2157 10/05/2023 0 NICU 1 4500.00 0.00
306336 318949 09/05/2023 19/05/2023 Female Baby Of SANSKRUTI PATIL 2155 10/05/2023 0 NICU 1 4500.00 0.00
SERVICE CODE : 9600012 - RDP Process Charges 2800.00 0.00
306339 318957 09/05/2023 13/05/2023 Mast SIDDIQUI IMRAN HALARI 2152 10/05/2023 509621 PICU 4 2800.00 0.00
SERVICE CODE : 9600016 - RDP Service Charges 1600.00 0.00
306339 318957 09/05/2023 13/05/2023 Mast SIDDIQUI IMRAN HALARI 2152 10/05/2023 509621 PICU 4 1600.00 0.00

REV. DATE: 11/05/2023 2400.00 0.00

CHARGE CODE: 96 - Blood Bank 2400.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00
306339 318957 09/05/2023 13/05/2023 Mast SIDDIQUI IMRAN HALARI 2161 11/05/2023 509621 PICU 2 2400.00 0.00
SERVICE CODE : 9600012 - RDP Process Charges 0.00 0.00
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509517 Triple Sharing -2 -1400.00 0.00
Date : 07/06/2023 Pa

Time : 07:09 PM User

In Patient Charge Wise Service Wise Details
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/05/2023 To 31/05/2023
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509552 Triple Sharing 2 1400.00 0.00
SERVICE CODE : 9600016 - RDP Service Charges 0.00 0.00
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509517 Triple Sharing -2 -800.00 0.00
306295 318869 06/05/2023 12/05/2023 Miss. SANJANA PRAKASH PATIL 2139 08/05/2023 509552 Triple Sharing 2 800.00 0.00

REV. DATE: 12/05/2023 4800.00 0.00

CHARGE CODE: 96 - Blood Bank 4800.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 4800.00 0.00
306357 146108 10/05/2023 14/05/2023 Mast KAVIR RAVI PATEL 2163 12/05/2023 509598 Single Ac Room 1 1200.00 0.00
306373 318718 11/05/2023 15/05/2023 Mrs. SHWETA DAGA 2162 12/05/2023 509614 Twin Sharing 1 1200.00 0.00
306384 319078 12/05/2023 17/05/2023 Baby BHAVI PARHATE 2164 12/05/2023 509647 Triple Sharing 2 2400.00 0.00

REV. DATE: 13/05/2023 18930.00 0.00

CHARGE CODE: 96 - Blood Bank 18930.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 3600.00 0.00
306388 319084 12/05/2023 16/05/2023 Miss. MEENA BATHIJA 2169 13/05/2023 509634 Twin Sharing 2 2400.00 0.00
306392 319087 13/05/2023 19/05/2023 Mast DISHAN GAURAV NARANG 2170 13/05/2023 509686 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00
306343 318967 10/05/2023 20/05/2023 Male Baby Of JANHAVI JITESH SADIKALE 2168 13/05/2023 509645 NICU 1 4500.00 0.00
SERVICE CODE : 9600012 - RDP Process Charges 4200.00 0.00
306339 318957 09/05/2023 13/05/2023 Mast SIDDIQUI IMRAN HALARI 2165 13/05/2023 509621 PICU 4 2800.00 0.00
306384 319078 12/05/2023 17/05/2023 Baby BHAVI PARHATE 2166 13/05/2023 509647 Triple Sharing 2 1400.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00
306394 311802 13/05/2023 13/05/2023 Mrs. SUSHMA ANIL SAKARKAR 2167 13/05/2023 509611 Daycare 1 4230.00 0.00
SERVICE CODE : 9600016 - RDP Service Charges 2400.00 0.00
306339 318957 09/05/2023 13/05/2023 Mast SIDDIQUI IMRAN HALARI 2165 13/05/2023 509621 PICU 4 1600.00 0.00
306384 319078 12/05/2023 17/05/2023 Baby BHAVI PARHATE 2166 13/05/2023 509647 Triple Sharing 2 800.00 0.00

REV. DATE: 14/05/2023 850.00 0.00

CHARGE CODE: 96 - Blood Bank 850.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 850.00 0.00
306399 39411 14/05/2023 18/05/2023 Mrs. VAISHNAVI VIKAS NAIK 2171 14/05/2023 509664 Twin Sharing 1 850.00 0.00

REV. DATE: 15/05/2023 8400.00 0.00

CHARGE CODE: 96 - Blood Bank 8400.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 8400.00 0.00
306404 315547 14/05/2023 18/05/2023 Mrs. SRISHTI HARISH MEHTA 2172 15/05/2023 509659 Suite Lotus 1 1200.00 0.00
306405 319145 15/05/2023 17/05/2023 Mrs. SAFYA BHORE 2173 15/05/2023 509644 Single Ac Room 1 1200.00 0.00
306407 319153 15/05/2023 22/05/2023 Mrs. REHANA PARWEEN 2174 15/05/2023 509744 Economy 2 2400.00 0.00
306410 318318 15/05/2023 18/05/2023 Dr. (Mrs.) SHALU KUMARI 2175 15/05/2023 509661 Single Ac Room 1 1200.00 0.00
306415 319176 15/05/2023 21/05/2023 Mrs. SHABINA BI SHAKIL SHEIKH 2177 15/05/2023 509734 Single Ac Room 1 1200.00 0.00
306416 308881 15/05/2023 21/05/2023 Mrs. RASHI ARORA 2176 15/05/2023 509724 Single Ac Room 1 1200.00 0.00

REV. DATE: 16/05/2023 12910.00 0.00

CHARGE CODE: 96 - Blood Bank 12910.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 4450.00 0.00
306407 319153 15/05/2023 22/05/2023 Mrs. REHANA PARWEEN 2181 16/05/2023 509744 Economy 1 1200.00 0.00
306407 319153 15/05/2023 22/05/2023 Mrs. REHANA PARWEEN 2182 16/05/2023 509744 Economy 1 1200.00 0.00
306427 53461 16/05/2023 25/05/2023 Mast AARAV NARAIN 2180 16/05/2023 0 Twin Sharing 1 850.00 0.00
306428 319231 16/05/2023 20/05/2023 Mrs. SHILPA DEEPESH NAGWEKAR 2183 16/05/2023 509693 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 8460.00 0.00
Date : 07/06/2023 Pa

Time : 07:09 PM User

In Patient Charge Wise Service Wise Details
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/05/2023 To 31/05/2023
306407 319153 15/05/2023 22/05/2023 Mrs. REHANA PARWEEN 2178 16/05/2023 509744 Economy 1 4230.00 0.00
306407 319153 15/05/2023 22/05/2023 Mrs. REHANA PARWEEN 2179 16/05/2023 509744 Economy 1 4230.00 0.00

REV. DATE: 17/05/2023 12600.00 0.00

CHARGE CODE: 96 - Blood Bank 12600.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 3600.00 0.00
306433 319235 17/05/2023 27/05/2023 Male Baby Of MEGHNA TWIN 1 MENON 2188 17/05/2023 509685 NICU 1 1200.00 0.00
306436 319242 17/05/2023 20/05/2023 Mrs. MANJU S PARMAR 2184 17/05/2023 509707 Twin Sharing 1 1200.00 0.00
306445 319276 17/05/2023 18/05/2023 Mrs. SAMIKSHA GUPTA 2187 17/05/2023 509663 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 9000.00 0.00
305785 317223 03/04/2023 13/04/2023 Male Baby Of ZALAKBEN ADESHARA 2186 17/05/2023 0 NICU 1 4500.00 0.00
306343 318967 10/05/2023 20/05/2023 Male Baby Of JANHAVI JITESH SADIKALE 2168 13/05/2023 509645 NICU -1 -4500.00 0.00
306343 318967 10/05/2023 20/05/2023 Male Baby Of JANHAVI JITESH SADIKALE 2168 13/05/2023 0 NICU 1 4500.00 0.00
306434 319236 17/05/2023 27/05/2023 Male Baby Of MEGHNA TWIN 2 MENON 2185 17/05/2023 0 NICU 1 4500.00 0.00

REV. DATE: 18/05/2023 1200.00 0.00

CHARGE CODE: 96 - Blood Bank 1200.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 1200.00 0.00
306229 318669 02/05/2023 12/05/2023 Female Baby Of MAMTA TWIN 2 BORAR 2189 18/05/2023 0 NICU 1 1200.00 0.00
306445 319276 17/05/2023 18/05/2023 Mrs. SAMIKSHA GUPTA 2187 17/05/2023 509663 Single Ac Room -1 -1200.00 0.00
306445 319276 17/05/2023 18/05/2023 Mrs. SAMIKSHA GUPTA 2187 17/05/2023 509673 Single Ac Room 1 1200.00 0.00

REV. DATE: 19/05/2023 7250.00 0.00

CHARGE CODE: 96 - Blood Bank 7250.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 2750.00 0.00
306427 53461 16/05/2023 25/05/2023 Mast AARAV NARAIN 2180 16/05/2023 0 Twin Sharing -1 -850.00 0.00
306433 319235 17/05/2023 27/05/2023 Male Baby Of MEGHNA TWIN 1 MENON 2188 17/05/2023 509685 NICU -1 -1200.00 0.00
306433 319235 17/05/2023 27/05/2023 Male Baby Of MEGHNA TWIN 1 MENON 2188 17/05/2023 0 NICU 1 1200.00 0.00
306458 319299 18/05/2023 21/05/2023 Mrs. NEDA SHAIKH 2190 19/05/2023 509727 Single Ac Room 1 1200.00 0.00
306464 53008 19/05/2023 22/05/2023 Mrs. VARSHA WAMBURKAR 2192 19/05/2023 509692 Single Ac Room 1 1200.00 0.00
306471 319331 19/05/2023 22/05/2023 Mrs. MANISHA B LIMBACHI 2193 19/05/2023 509698 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00
306229 318669 02/05/2023 12/05/2023 Female Baby Of MAMTA TWIN 2 BORAR 2191 19/05/2023 0 NICU 1 4500.00 0.00

REV. DATE: 20/05/2023 33750.00 0.00

CHARGE CODE: 96 - Blood Bank 33750.00 0.00
SERVICE CODE : 9600006 - Irradiation 2400.00 0.00
306487 291023 20/05/2023 22/05/2023 Miss. NIRVI SANTOSH KUSHE 2194 20/05/2023 509736 Economy 1 1200.00 0.00
306489 279949 20/05/2023 21/05/2023 Miss. THRIDA MAHESH JADHAV 2196 20/05/2023 509716 Twin Sharing -1 -1200.00 0.00
306489 279949 20/05/2023 21/05/2023 Miss. THRIDA MAHESH JADHAV 2196 20/05/2023 509725 Twin Sharing 1 1200.00 0.00
306489 279949 20/05/2023 21/05/2023 Miss. THRIDA MAHESH JADHAV 2196 20/05/2023 509716 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 1200.00 0.00
306464 53008 19/05/2023 22/05/2023 Mrs. VARSHA WAMBURKAR 2192 19/05/2023 509692 Single Ac Room -1 -1200.00 0.00
306464 53008 19/05/2023 22/05/2023 Mrs. VARSHA WAMBURKAR 2192 19/05/2023 509705 Single Ac Room 1 1200.00 0.00
306464 53008 19/05/2023 22/05/2023 Mrs. VARSHA WAMBURKAR 2192 19/05/2023 509705 Single Ac Room -1 -1200.00 0.00
306464 53008 19/05/2023 22/05/2023 Mrs. VARSHA WAMBURKAR 2192 19/05/2023 509745 Single Ac Room 1 1200.00 0.00
306471 319331 19/05/2023 22/05/2023 Mrs. MANISHA B LIMBACHI 2193 19/05/2023 509698 Twin Sharing -1 -1200.00 0.00
306471 319331 19/05/2023 22/05/2023 Mrs. MANISHA B LIMBACHI 2193 19/05/2023 509746 Twin Sharing 1 1200.00 0.00
306479 307822 20/05/2023 22/05/2023 Dr. (Mrs.) TIA SATWANI 2197 20/05/2023 509748 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 9000.00 0.00
306491 319395 20/05/2023 25/05/2023 Male Baby Of ASTHA TWIN 2 BISHNOI 2195 20/05/2023 509816 NICU 1 4500.00 0.00
306492 319408 20/05/2023 30/05/2023 Male Baby Of SHAMIN COUTINHO 2200 20/05/2023 0 NICU 1 4500.00 0.00
Date : 07/06/2023 Pa

Time : 07:09 PM User

In Patient Charge Wise Service Wise Details
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/05/2023 To 31/05/2023
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 21150.00 0.00
306487 291023 20/05/2023 22/05/2023 Miss. NIRVI SANTOSH KUSHE 2194 20/05/2023 509736 Economy 1 4230.00 0.00
306489 279949 20/05/2023 21/05/2023 Miss. THRIDA MAHESH JADHAV 2196 20/05/2023 509716 Twin Sharing -1 -4230.00 0.00
306489 279949 20/05/2023 21/05/2023 Miss. THRIDA MAHESH JADHAV 2196 20/05/2023 509725 Twin Sharing 1 4230.00 0.00
306489 279949 20/05/2023 21/05/2023 Miss. THRIDA MAHESH JADHAV 2196 20/05/2023 509716 Twin Sharing 1 4230.00 0.00
306494 317913 20/05/2023 25/05/2023 Mrs. VIDHYA PATIL 2198 20/05/2023 509794 Economy 1 4230.00 0.00
306495 318459 20/05/2023 23/05/2023 Mrs. ADITI KUSHAL JADHAV 2199 20/05/2023 509766 Triple Sharing 1 4230.00 0.00
306495 318459 20/05/2023 23/05/2023 Mrs. ADITI KUSHAL JADHAV 2201 20/05/2023 509766 Triple Sharing 1 4230.00 0.00

REV. DATE: 21/05/2023 12330.00 0.00

CHARGE CODE: 96 - Blood Bank 12330.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 3600.00 0.00
306494 317913 20/05/2023 25/05/2023 Mrs. VIDHYA PATIL 2205 21/05/2023 509794 Economy 1 1200.00 0.00
306495 318459 20/05/2023 23/05/2023 Mrs. ADITI KUSHAL JADHAV 2206 21/05/2023 0 Triple Sharing 1 1200.00 0.00
306495 318459 20/05/2023 23/05/2023 Mrs. ADITI KUSHAL JADHAV 2202 21/05/2023 509766 Triple Sharing 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00
305534 316454 19/03/2023 06/06/2023 Male Baby Of SIMRAN CHAWLA 2204 21/05/2023 510035 Single Ac Room 1 4500.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00
306494 317913 20/05/2023 25/05/2023 Mrs. VIDHYA PATIL 2203 21/05/2023 509794 Economy 1 4230.00 0.00

REV. DATE: 22/05/2023 23550.00 0.00

CHARGE CODE: 96 - Blood Bank 23550.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00
306506 118620 22/05/2023 24/05/2023 Mrs. VAISHALI CHAVAN 2207 22/05/2023 509782 Single Ac Room 1 1200.00 0.00
306507 154641 22/05/2023 25/05/2023 Mrs. PRIYANKA KUPERKAR 2209 22/05/2023 509795 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 21150.00 0.00
306494 317913 20/05/2023 25/05/2023 Mrs. VIDHYA PATIL 2210 22/05/2023 509794 Economy 1 4230.00 0.00
306494 317913 20/05/2023 25/05/2023 Mrs. VIDHYA PATIL 2211 22/05/2023 509794 Economy 1 4230.00 0.00
306495 318459 20/05/2023 23/05/2023 Mrs. ADITI KUSHAL JADHAV 2208 22/05/2023 509766 Triple Sharing 1 4230.00 0.00
306509 160334 22/05/2023 22/05/2023 Mrs. RITIKA PODDAR 2213 22/05/2023 509750 Single Ac Room 1 4230.00 0.00
306513 317717 22/05/2023 23/05/2023 Mast DIRASH HANISH SHAH 2212 22/05/2023 0 Twin Sharing 1 4230.00 0.00

REV. DATE: 23/05/2023 17970.00 0.00

CHARGE CODE: 96 - Blood Bank 17970.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 13200.00 0.00
306427 53461 16/05/2023 25/05/2023 Mast AARAV NARAIN 2223 23/05/2023 509804 Twin Sharing 1 1200.00 0.00
306495 318459 20/05/2023 23/05/2023 Mrs. ADITI KUSHAL JADHAV 2206 21/05/2023 0 Triple Sharing -1 -1200.00 0.00
306504 319439 21/05/2023 25/05/2023 Mrs. MEENA JITENDRA DAVAY 2214 23/05/2023 509807 Twin Sharing 1 1200.00 0.00
306512 307004 22/05/2023 27/05/2023 Mrs. PREETI NITIN TIWARI 2215 23/05/2023 509836 Single Ac Room 1 1200.00 0.00
306513 317717 22/05/2023 23/05/2023 Mast DIRASH HANISH SHAH 2219 23/05/2023 509764 Twin Sharing 2 2400.00 0.00
306513 317717 22/05/2023 23/05/2023 Mast DIRASH HANISH SHAH 2221 23/05/2023 509764 Twin Sharing 1 1200.00 0.00
306521 280096 22/05/2023 25/05/2023 Mrs. VERTIKA VARDHAN 2218 23/05/2023 509811 Single Ac Room 1 1200.00 0.00
306524 317046 22/05/2023 26/05/2023 Dr. (Mrs.) CHAITRALI KARAN KAKADE 2216 23/05/2023 509820 Single Ac Room 3 3600.00 0.00
306527 317512 22/05/2023 27/05/2023 Mrs. PHOOLKALI SHARMA 2217 23/05/2023 509751 Single Ac Room 1 1200.00 0.00
306527 317512 22/05/2023 27/05/2023 Mrs. PHOOLKALI SHARMA 2217 23/05/2023 509751 Single Ac Room -1 -1200.00 0.00
306527 317512 22/05/2023 27/05/2023 Mrs. PHOOLKALI SHARMA 2217 23/05/2023 509835 Single Ac Room 1 1200.00 0.00
306535 157529 23/05/2023 24/05/2023 Mrs. IVONA PEREIRA 2220 23/05/2023 509772 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 9000.00 0.00
306433 319235 17/05/2023 27/05/2023 Male Baby Of MEGHNA TWIN 1 MENON 2222 23/05/2023 0 NICU 1 4500.00 0.00
306517 319459 22/05/2023 01/06/2023 Female Baby Of RASHMI NARKAR 2224 23/05/2023 0 NICU 1 4500.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) -4230.00 0.00
306513 317717 22/05/2023 23/05/2023 Mast DIRASH HANISH SHAH 2212 22/05/2023 0 Twin Sharing -1 -4230.00 0.00
Date : 07/06/2023 Pa

Time : 07:09 PM User

In Patient Charge Wise Service Wise Details
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/05/2023 To 31/05/2023
REV. DATE: 24/05/2023 42000.00 0.00
CHARGE CODE: 96 - Blood Bank 42000.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 6000.00 0.00
306548 153708 23/05/2023 27/05/2023 Mrs. SHREYA PODAR 2225 24/05/2023 509832 Single Ac Room 1 1200.00 0.00
306551 131870 24/05/2023 25/05/2023 Mrs. MRUNALINI SAMBHARE 2227 24/05/2023 509799 Twin Sharing 1 1200.00 0.00
306553 309628 24/05/2023 26/05/2023 Mrs. BRINDHA GURURAJ RAO 2226 24/05/2023 509924 Single Ac Room 1 1200.00 0.00
306563 310846 24/05/2023 29/05/2023 Mrs. ZAINAB SAHERWALA 2233 24/05/2023 509877 Single Ac Room 1 1200.00 0.00
306565 41780 24/05/2023 28/05/2023 Mrs. VARSHA GORE 2234 24/05/2023 509863 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 36000.00 0.00
305868 317541 09/04/2023 19/04/2023 Male Baby Of DHARA MEHTA 2230 24/05/2023 0 NICU 1 4500.00 0.00
306018 317951 18/04/2023 28/04/2023 Male Baby Of SNEHAL SATNAK 2231 24/05/2023 0 NICU 1 4500.00 0.00
306490 319394 20/05/2023 30/05/2023 Male Baby Of ASTHA TWIN 1 BISHNOI 2236 24/05/2023 0 NICU 1 4500.00 0.00
306490 319394 20/05/2023 30/05/2023 Male Baby Of ASTHA TWIN 1 BISHNOI 2229 24/05/2023 0 NICU 1 4500.00 0.00
306491 319395 20/05/2023 25/05/2023 Male Baby Of ASTHA TWIN 2 BISHNOI 2237 24/05/2023 509816 NICU 1 4500.00 0.00
306517 319459 22/05/2023 01/06/2023 Female Baby Of RASHMI NARKAR 2232 24/05/2023 0 NICU 1 4500.00 0.00
306529 319487 22/05/2023 01/06/2023 Female Baby Of RUTUJA PRATIK LACHAKE 2228 24/05/2023 509934 NICU 1 4500.00 0.00
306529 319487 22/05/2023 01/06/2023 Female Baby Of RUTUJA PRATIK LACHAKE 2235 24/05/2023 0 NICU 1 4500.00 0.00

REV. DATE: 25/05/2023 -2070.00 0.00

CHARGE CODE: 96 - Blood Bank -2070.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 8400.00 0.00
306564 315841 24/05/2023 29/05/2023 Mrs. NIKKE ROMIT AGARWAL 2238 25/05/2023 509870 Single Ac Room 1 1200.00 0.00
306567 319584 24/05/2023 29/05/2023 Mrs. PRATEETI GOYAL 2241 25/05/2023 509865 Suite Marigold 1 1200.00 0.00
306570 319589 24/05/2023 27/05/2023 Mrs. KAJAL BHARAT KOTHARI 2239 25/05/2023 509805 Single Ac Room 1 1200.00 0.00
306570 319589 24/05/2023 27/05/2023 Mrs. KAJAL BHARAT KOTHARI 2239 25/05/2023 509805 Single Ac Room -1 -1200.00 0.00
306570 319589 24/05/2023 27/05/2023 Mrs. KAJAL BHARAT KOTHARI 2239 25/05/2023 509839 Single Ac Room 1 1200.00 0.00
306571 318663 24/05/2023 28/05/2023 Mrs. DR.MERLIN SALDANHA 2240 25/05/2023 509861 Single Ac Room 1 1200.00 0.00
306577 319600 25/05/2023 27/05/2023 Mrs. ROSHANI VICHARE 2243 25/05/2023 509843 Single Ac Room 2 2400.00 0.00
306581 319520 25/05/2023 27/05/2023 Mrs. NUPUR WARKE 2242 25/05/2023 509831 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag -13500.00 0.00
306490 319394 20/05/2023 30/05/2023 Male Baby Of ASTHA TWIN 1 BISHNOI 2236 24/05/2023 0 NICU -1 -4500.00 0.00
306517 319459 22/05/2023 01/06/2023 Female Baby Of RASHMI NARKAR 2232 24/05/2023 0 NICU -1 -4500.00 0.00
306529 319487 22/05/2023 01/06/2023 Female Baby Of RUTUJA PRATIK LACHAKE 2235 24/05/2023 0 NICU -1 -4500.00 0.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 3030.00 0.00
306591 299245 25/05/2023 27/05/2023 Miss. RAKSHA DALAL 2244 25/05/2023 509840 ICU 1 3030.00 0.00

REV. DATE: 26/05/2023 12790.00 0.00

CHARGE CODE: 96 - Blood Bank 12790.00 0.00
SERVICE CODE : 9600004 - FFP Process Charges 700.00 0.00
306590 319629 25/05/2023 26/05/2023 Mast KRIYANSH YOGESH KHARAT 2249 26/05/2023 509829 PICU 1 700.00 0.00
SERVICE CODE : 9600005 - FFP Service Charges 600.00 0.00
306590 319629 25/05/2023 26/05/2023 Mast KRIYANSH YOGESH KHARAT 2250 26/05/2023 509829 PICU 3 600.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 2400.00 0.00
306584 310289 25/05/2023 29/05/2023 Mrs. DISHA BHUTA 2247 26/05/2023 509872 Twin Sharing 1 1200.00 0.00
306595 145345 25/05/2023 29/05/2023 Mrs. MITTAL SAWANT 2245 26/05/2023 509881 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 9090.00 0.00
306591 299245 25/05/2023 27/05/2023 Miss. RAKSHA DALAL 2246 26/05/2023 509840 ICU 2 6060.00 0.00
306599 318767 26/05/2023 26/05/2023 Mr. CHIMAN MOHAN PURABIYA 2248 26/05/2023 509828 Daycare 1 3030.00 0.00

REV. DATE: 27/05/2023 13800.00 0.00

CHARGE CODE: 96 - Blood Bank 13800.00 0.00
Date : 07/06/2023 Pa

Time : 07:09 PM User

In Patient Charge Wise Service Wise Details
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/05/2023 To 31/05/2023
SERVICE CODE : 9600010 - PRBC Service Charges 4800.00 0.00
306592 317141 25/05/2023 31/05/2023 Mrs. REENA VISHAL NARNAVRE 2254 27/05/2023 509911 Twin Sharing 1 1200.00 0.00
306594 319644 25/05/2023 06/06/2023 Mr. SHARIF KHAN 2252 27/05/2023 510019 Twin Sharing 1 1200.00 0.00
306602 319669 26/05/2023 31/05/2023 Mast ATHARV GUPTA 2255 27/05/2023 509914 PICU 1 1200.00 0.00
306604 308883 26/05/2023 30/05/2023 Mrs. SUNILA SAMEER KOPARKAR 2251 27/05/2023 509897 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 9000.00 0.00
306605 319675 26/05/2023 05/06/2023 Female Baby Of MITTAL SAWANT 2253 27/05/2023 0 NICU 1 4500.00 0.00
306617 319713 27/05/2023 06/06/2023 Male Baby Of GETHCIAL LAWRENCE NADAR 2256 27/05/2023 0 NICU 1 4500.00 0.00

REV. DATE: 28/05/2023 9030.00 0.00

CHARGE CODE: 96 - Blood Bank 9030.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 4800.00 0.00
306614 313479 27/05/2023 31/05/2023 Miss. KAYRA RAHULKUMAR PATEL 2259 28/05/2023 509918 Twin Sharing 1 1200.00 0.00
306621 319729 27/05/2023 01/06/2023 Mrs. POONAM PATEL 2257 28/05/2023 509927 Twin Sharing 2 2400.00 0.00
306622 319733 28/05/2023 29/05/2023 Mrs. SHREELEKHA CHAKRABORTY 2260 28/05/2023 509891 Twin Sharing 1 1200.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00
306621 319729 27/05/2023 01/06/2023 Mrs. POONAM PATEL 2258 28/05/2023 509927 Twin Sharing 1 4230.00 0.00

REV. DATE: 29/05/2023 12130.00 0.00

CHARGE CODE: 96 - Blood Bank 12130.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 1200.00 0.00
306584 310289 25/05/2023 29/05/2023 Mrs. DISHA BHUTA 2247 26/05/2023 509872 Twin Sharing -1 -1200.00 0.00
306584 310289 25/05/2023 29/05/2023 Mrs. DISHA BHUTA 2247 26/05/2023 509875 Twin Sharing 1 1200.00 0.00
306624 319734 28/05/2023 02/06/2023 Mrs. HASINA ABBUBAKKAR SAYED 2261 29/05/2023 509868 Economy 1 1200.00 0.00
306624 319734 28/05/2023 02/06/2023 Mrs. HASINA ABBUBAKKAR SAYED 2261 29/05/2023 509868 Economy -1 -1200.00 0.00
306624 319734 28/05/2023 02/06/2023 Mrs. HASINA ABBUBAKKAR SAYED 2261 29/05/2023 509974 Economy 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00
305664 316856 27/03/2023 06/04/2023 Male Baby Of KHUSHBU SINGH 2263 29/05/2023 0 NICU 1 4500.00 0.00
SERVICE CODE : 9600012 - RDP Process Charges 1400.00 0.00
306617 319713 27/05/2023 06/06/2023 Male Baby Of GETHCIAL LAWRENCE NADAR 2262 29/05/2023 0 NICU 2 1400.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00
306637 319775 29/05/2023 03/06/2023 Mrs. CLARA FERNANDES 2264 29/05/2023 509981 Triple Sharing 1 4230.00 0.00
SERVICE CODE : 9600016 - RDP Service Charges 800.00 0.00
306617 319713 27/05/2023 06/06/2023 Male Baby Of GETHCIAL LAWRENCE NADAR 2262 29/05/2023 0 NICU 2 800.00 0.00

REV. DATE: 30/05/2023 23460.00 0.00

CHARGE CODE: 96 - Blood Bank 23460.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 8400.00 0.00
306592 317141 25/05/2023 31/05/2023 Mrs. REENA VISHAL NARNAVRE 2268 30/05/2023 509911 Twin Sharing 1 1200.00 0.00
306631 319749 29/05/2023 03/06/2023 Mrs. NEELAM MOLWANE 2272 30/05/2023 509979 Twin Sharing 1 1200.00 0.00
306632 311879 29/05/2023 05/06/2023 Mast DAIVIK AGARWAL 2265 30/05/2023 510014 Twin Sharing 1 1200.00 0.00
306644 319798 30/05/2023 01/06/2023 Mrs. JULIE PARKAR 2267 30/05/2023 510007 Twin Sharing 1 1200.00 0.00
306646 318463 30/05/2023 01/06/2023 Mrs. ALEESHA MASHRU 2269 30/05/2023 509921 Single Ac Room 1 1200.00 0.00
306647 319808 30/05/2023 01/06/2023 Mrs. RIDDHI MEHTA 2270 30/05/2023 509929 Single Ac Room 1 1200.00 0.00
306651 319831 30/05/2023 02/06/2023 Dr. (Mrs.) DARSHANA PATIL 2273 30/05/2023 509913 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 9000.00 0.00
306038 318020 19/04/2023 29/04/2023 Female Baby Of POOJA KOTHARI 2274 30/05/2023 0 NICU 1 4500.00 0.00
306528 317166 22/05/2023 04/06/2023 Male Baby Of SOHINI JAIN-GHARAT 2275 30/05/2023 510020 Single Ac Room 1 4500.00 0.00
SERVICE CODE : 9600015 - PRBC Process Charges ( without NAT) 6060.00 0.00
306637 319775 29/05/2023 03/06/2023 Mrs. CLARA FERNANDES 2266 30/05/2023 509981 Triple Sharing 1 3030.00 0.00
Date : 07/06/2023 Pa

Time : 07:09 PM User

In Patient Charge Wise Service Wise Details
Charge : Blood Bank Service : Selected Services User ID : All For All Patients From 1/05/2023 To 31/05/2023
306637 319775 29/05/2023 03/06/2023 Mrs. CLARA FERNANDES 2271 30/05/2023 509981 Triple Sharing 1 3030.00 0.00

REV. DATE: 31/05/2023 9930.00 0.00

CHARGE CODE: 96 - Blood Bank 9930.00 0.00
SERVICE CODE : 9600010 - PRBC Service Charges 1200.00 0.00
306637 319775 29/05/2023 03/06/2023 Mrs. CLARA FERNANDES 2278 31/05/2023 509981 Triple Sharing 1 1200.00 0.00
306651 319831 30/05/2023 02/06/2023 Dr. (Mrs.) DARSHANA PATIL 2273 30/05/2023 509913 Single Ac Room -1 -1200.00 0.00
306651 319831 30/05/2023 02/06/2023 Dr. (Mrs.) DARSHANA PATIL 2273 30/05/2023 509968 Single Ac Room 1 1200.00 0.00
SERVICE CODE : 9600011 - PRBC Triple Attached Bag 4500.00 0.00
306653 319839 30/05/2023 09/06/2023 Female Baby Of NEELAM MOLWANE 2276 31/05/2023 0 NICU 1 4500.00 0.00
SERVICE CODE : 9600014 - PRBC Process Charges (NAT) 4230.00 0.00
306621 319729 27/05/2023 01/06/2023 Mrs. POONAM PATEL 2277 31/05/2023 509927 Twin Sharing 1 4230.00 0.00

Grand Total : 407640.00 0.00

-End Of Report-
 Page 1 of 1

User : ARUNH

Net Amt
3600.00
3600.00
3600.00
-1200.00
1200.00
1200.00
1200.00
1200.00

8100.00
8100.00
3600.00
-1200.00
1200.00
-1200.00
1200.00
1200.00
1200.00
1200.00
4500.00
4500.00

13200.00
13200.00
400.00
400.00
8400.00
1200.00
2400.00
1200.00
1200.00
1200.00
1200.00
2800.00
2800.00
1600.00
1600.00

14730.00
14730.00
7200.00
-1200.00
1200.00
-1200.00
1200.00
-1200.00
1200.00
2400.00
1200.00
1200.00
1200.00
 Page 1 of 1

User : ARUNH

1200.00
4500.00
4500.00
3030.00
3030.00

10860.00
10860.00
1200.00
1200.00
2400.00
1200.00
1200.00
4230.00
4230.00
3030.00
3030.00

16860.00
16860.00
9600.00
4800.00
1200.00
1200.00
1200.00
1200.00
4230.00
4230.00
3030.00
3030.00

6060.00
6060.00
6060.00
3030.00
3030.00

4600.00
4600.00
2400.00
1200.00
1200.00
1400.00
1400.00
800.00
800.00

23820.00
23820.00
 Page 1 of 1

User : ARUNH

6000.00
1200.00
1200.00
1200.00
1200.00
1200.00
4500.00
4500.00
0.00
-1400.00
1400.00
4230.00
4230.00
9090.00
3030.00
3030.00
3030.00
0.00
-800.00
800.00

27800.00
27800.00
1400.00
700.00
700.00
400.00
400.00
3600.00
-1200.00
1200.00
2400.00
1200.00
18000.00
4500.00
4500.00
4500.00
4500.00
2800.00
2800.00
1600.00
1600.00

2400.00
2400.00
2400.00
2400.00
0.00
-1400.00
 Page 1 of 1

User : ARUNH

1400.00
0.00
-800.00
800.00

4800.00
4800.00
4800.00
1200.00
1200.00
2400.00

18930.00
18930.00
3600.00
2400.00
1200.00
4500.00
4500.00
4200.00
2800.00
1400.00
4230.00
4230.00
2400.00
1600.00
800.00

850.00
850.00
850.00
850.00

8400.00
8400.00
8400.00
1200.00
1200.00
2400.00
1200.00
1200.00
1200.00

12910.00
12910.00
4450.00
1200.00
1200.00
850.00
1200.00
8460.00
 Page 1 of 1

User : ARUNH

4230.00
4230.00

12600.00
12600.00
3600.00
1200.00
1200.00
1200.00
9000.00
4500.00
-4500.00
4500.00
4500.00

1200.00
1200.00
1200.00
1200.00
-1200.00
1200.00

7250.00
7250.00
2750.00
-850.00
-1200.00
1200.00
1200.00
1200.00
1200.00
4500.00
4500.00

33750.00
33750.00
2400.00
1200.00
-1200.00
1200.00
1200.00
1200.00
-1200.00
1200.00
-1200.00
1200.00
-1200.00
1200.00
1200.00
9000.00
4500.00
4500.00
 Page 1 of 1

User : ARUNH

21150.00
4230.00
-4230.00
4230.00
4230.00
4230.00
4230.00
4230.00

12330.00
12330.00
3600.00
1200.00
1200.00
1200.00
4500.00
4500.00
4230.00
4230.00

23550.00
23550.00
2400.00
1200.00
1200.00
21150.00
4230.00
4230.00
4230.00
4230.00
4230.00

17970.00
17970.00
13200.00
1200.00
-1200.00
1200.00
1200.00
2400.00
1200.00
1200.00
3600.00
1200.00
-1200.00
1200.00
1200.00
9000.00
4500.00
4500.00
-4230.00
-4230.00
 Page 1 of 1

User : ARUNH

42000.00
42000.00
6000.00
1200.00
1200.00
1200.00
1200.00
1200.00
36000.00
4500.00
4500.00
4500.00
4500.00
4500.00
4500.00
4500.00
4500.00

-2070.00
-2070.00
8400.00
1200.00
1200.00
1200.00
-1200.00
1200.00
1200.00
2400.00
1200.00
-13500.00
-4500.00
-4500.00
-4500.00
3030.00
3030.00

12790.00
12790.00
700.00
700.00
600.00
600.00
2400.00
1200.00
1200.00
9090.00
6060.00
3030.00

13800.00
13800.00
 Page 1 of 1

User : ARUNH

4800.00
1200.00
1200.00
1200.00
1200.00
9000.00
4500.00
4500.00

9030.00
9030.00
4800.00
1200.00
2400.00
1200.00
4230.00
4230.00

12130.00
12130.00
1200.00
-1200.00
1200.00
1200.00
-1200.00
1200.00
4500.00
4500.00
1400.00
1400.00
4230.00
4230.00
800.00
800.00

23460.00
23460.00
8400.00
1200.00
1200.00
1200.00
1200.00
1200.00
1200.00
1200.00
9000.00
4500.00
4500.00
6060.00
3030.00
 Page 1 of 1

User : ARUNH

3030.00

9930.00
9930.00
1200.00
1200.00
-1200.00
1200.00
4500.00
4500.00
4230.00
4230.00

407640.00