APOLLO HOSPITALS EMERGENCY1066

Opposite IMB,154/11, Amalodbhavi Nagar, Panduranga Nagar,

|Apollo Bangalore - 560076 (India)
HOSPITALS Tel.: +(91)-80-26304050/26304051 Fax: +(91)-80-41463151
T OUCHINGLVES

INPATIENT BILL
PATIENTDETAILS IP No,:97101 ID No. : 0000246611

Saravana kumar V Bill No, : ICR33504

A2 Nagesan nagar Bill Dt./Time: 13-Jan-2013 10:06 AM

Vadalur
Cuddalore taluk
Admission Dt./Time:10-Jan-2014 7:22 AM
TamilNadu
Discahrge Dt./Time: 13-Jan-2014 10:06 AM

DETAILS
Service Name Amount(Rs.)
ROOM RENT 4.000.00
PHARMACY 2,765.54
MEDICAL EQUIPMENT 1,000.00
CONSULTATIONS 2,400.00
CONSUMABLES 2,118.00
INVESTIGATIONS 2,860.00

Bill Amount 15,143.54

In Words:
Fifteen Thousand Hundred Forty Three Rupees and Fifty Four Paise.

Refundable Deposit As On 13-Jan-2014 10:05 AM Rs.5000

This is a computer generated statement and requires no signature.

This Recelpt is valid for an employer or Insurer, who is contractually obligated to reimburse the medical expenses covered by MediSave
and/or MediShield.

For billing and general enquirles, please mail: customercare bangalore@apollohospitals.com

O Apollo Hospitals, Bangalore 2013, All Rights reserved