Receipt - 25-10-2021 (1.)

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Hospital
BILL REF. NO. B!LL DATE LOCATION
1522261982J-00001 25 OCT 2021 HAND RECON MICROSURGERY CENTRE

MR. UM UK WEE NRIC/F1N/MRN


VISIT DATE > 25 OCT 2021 02:25 PM
SXXXX755B

BLK 39B #02-01


JALAN PEMIMPIN
SURVIVAL SYSTEMS
INTERNATIONAL OFFSHORE
SINGAPORE- 577184

TOTAL AMOUNT (BEFORE GST) $ 322.90


7% G ST $ 22.60
TOTAL AMOUNT $ 345.50
TOTAL AMOUNT PAYABLE 345.50
Net Payment msde -345.50

FINAL AMOUNT PAYABLE 0.00

FINAL AMOUNT PAYABLE

CHARGES
SERVICES DESCRIPTION AMOUNT ($)

CONSULTATION FEE Consultation Services (SC - FV} 136.00

INVESTIGATIONS X-ray

XR, Hand, Right, PA, oblique, Laterai 56.70

XR, WRIST JOINT, RIGHT 38.20

THERAPY SERVICES Occupational Therapy

Orthosis 35.00

Orthosis Fitting / Assessment 2 57.00

TOTAL AMOUNT (BEFORE GST) 322.90

7% 65T 22.60

TOTAL AMOUNT 345.50

PAYMENT SUMMARY
TOTAL AMOUNT 345.50

SCHEMES (SCHEME ID} / PAYOR REFERENCE NO. AMOUNT PAYABLE ($[

MR. LIM UK WEE 345.50

Payment Summary to be continued on page 2

PFiiNTED ON: 25 OCT 2021 0&:D2 PM

National University Hospital {S) Pte Ltd | www.nuh.com.sg For bi!! enquiries, please contact us at
5 Lower Kent Ridge Road, Singapore 119074 | Tel; +65 6779 5555 Emsii: payment@'!fss.com.sg

Company Registration No. 198500843R | GST Reg No. M2-0069889-4 Tel:+65 6407 8138
National University Page 2 of 2

Hospllal
BILL REF. NO. BILL DATE PATiENT NAME
1522261982J-00001 25 OCT 2021 MR. LIM UK WEE
NRIC/FIN/MRN
SXXXX7558

MR. LIM UK WEE TOTAL AMOUNT PAYABLE 345.50


PAYOR(S) TRANSACTION/RECEIPT PAYMENT MODE AMOUNT (s?)
DATE

MR. UM UK WEE

Net Payment made


WITH REFERRAL - INTRA-HOSP A&E .
THIS TAX iNVOSCE SUPERSEDES ALL PREVIOUS
TAX iNVOICES FOR YOUR VISIT ON 25.10.2021 . FINAL AMOUNT PAYABLE

PAYMENT OPTIONS & ADVISORY


Payment Policy
* Credit baisnce from your bill will be U5ed to offset any other outstanding bills that you may have within the same payment account.
* If no biii number is indicated, the payment received wilt be used to offset the oldest outstanding bill.
a Payment made via AXS and E-Payments wifi be updated to your biii within 3 working days.

PRINTED ON: 25 OCT 203-! 05.02 PM

National University Hospital (S) Pte Ltd j www.nuh.com.sg For bi!i enquiries, please contact us st
5 Lower Kent Ridge Road, Singapore 119074 [ Tel: +65 6779 5555 Email: [email protected]
Company Registration No, 198500S43R | GST Reg No. M2-0069889-4 Tel:+65 6407 81 38

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