Invoice

Patient Name: Dilip Dadhich Visit No.: KAL24061100

Age / Sex: 53 Y/M Invoice No.: SI24-25DL0130295
Mobile: 9315573476 Invoice Date: 15-Jun-24 09:03
UHID: UKAL.0000002556 Centre: SCF KALKAJI BLOCK B
Referred By: SELF GSTIN: 07AACCN6471F1ZG
Address: 1088/10 govindpuri kalkaji 3rd floor HSN / SAC : 999316

Code Description MRP Rate Net

PL0029 Uric Acid 198 99 INR 99.00

Total INR 99.00

Authorized Signature :
Billed by: HARPREET KAUR (KAL)
Kindly reach out to +91-9654880197, between 7:00 AM to 10:00 PM may you require any assistance

Reports are available online for 30 days. Thereafter report are archived for upto 3 years after the test.
Services provided hereunder are healthcare services which are exempt from GST under serial no. 74 of notification 12/2017 - Central Tax(Rate).
Images for all modalities film/CD once issued will be re-issued upon an additional charge as per rate list. Images are stored in databank for upto a period of 30 days only.
Thereafter the House Of Diagnostics dose not hold any responsibility / liability of issuance of any such Images on film/CD.
Films and Images are normally provided as hard copies. Incase images are needed on a CD, charges will be extra, at applicable rates.
Test Group with SIN No. beginning with OS are outsourced and not performed at the House of Diagnostics laboratory.
A Whole Body PETCT Scan is done for Head to Mid Thigh region.
No refunds will be made once test is performed.
Advance taken for PET CT scan is refundable as per below mentioned point 9, only if cancellation request is made before 8 PM, a day before the test scheduled date. Any
reason for cancellation. Thereafter shall result in forfeiture of Rs. 5000/-. Refund of any test on account of test not done, will take 10 days after completing needful paperwork
formalities and will be by NEFT only. Please provide complete Account details for the NEFT. HOD will not be liable incase wrong bank A/c details are provided. All refunds
will be subject to deduction of Rs. 50/- or 2% of the amount, whichever is higher.
Refund or Adjustment of any advance amount paid against any test must be utilized within 90 days of making payment/advance. All such amounts will stand forfeited after 90
days of making any advance payment. I, hereby give my consent for the above billed tests to be performed on me/my patient.
ICMR Registration Number for House Of Diagnostics is HDHPLDD.