SREE SANKALPA MULTI SPECIALITY HOPSITAL

GUNTURUVARI THOTA 8th LINE,ANDHRAPRADESHkOTHPETA,GUNTUR-522001

PH.:0000000000,0000000000
IP INVOICE

MR No. : 54/22-23 Invoice No : IP/P/22-23/22

IP ID : 000037/22-23 Bill Date : 04-Jan-2023
Patient Name : Mr.TEST Admit. Date : 14/12/2022 02:47:42 PM
Age/Sex : 2 months./Male Bed No./Ward : 115/DELUXE
Phone No. : 3333333333 Department : NA
ADDRESS : SF Discharge Date : 04-Jan-2023 06:54:29 PM
Doctor Name : Dr.CHAITANYA GANTA Patient Type : Cash
Ref. By : SELF F/M/H/W Name : DF

SI No. Services Days/Hrs/Visits/Use Rate(Rs.) Amount(Rs.)

HOSPITAL CHARGES
1 Casualty 1 500.00 500.00

Total Charges : 500.00

PAYMENT DETAILS:
Total Bill : 500.00
ReciptNo. Date Amount(Rs.) Mode
24 04/01/2023 500.00 Cash Balance Paid : 500.00

Amount In Words : Five Hundred Rupees Only.

For SREE SANKALPA MULTI SPECIALITY

Created By : Mr.Murthy S Akella
HOPSITAL

*Note-Please vacate the room maximum within 1 hour of generation of final bill as otherwise additional room/bed charge for a
day will be charged extra.