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    Gopi Nath

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    © All Rights Reserved
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    BIl Format

    Uploaded by

    Gopi Nath
    11 views1 page

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    Copyright:

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    11 views1 page

    BIl Format

    Uploaded by

    Gopi Nath

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    To Date:24-Jun-2024

    CPRMS-E/NE Trust
    Singareni Collieries Company Limited. Bill ID 62339
    Settlement of in Patient Hospitalisation Bill
    Bill No FB2425000250 Bill Date 12-Jun-2024
    IP OP No KIP2425000252 Admitted Date 07-Jun-2024
    Patient Name ADE GANGU Discharge Date 11-Jun-2024
    Emp Name ADE GANGU PerNum /MC_ID 912621 / 133798
    Consultant DR.M. VINOD KUMAR Relation SELF
    Diagnosis cad-unstable angina

    Particulars Amount
    INVESTIGATION
    CARDIOLOGY 3,160.00
    GENERAL MEDICINE 350.00
    HOSPITAL SERVICES 660.00
    ORTHOPAEDICS 1,050.00
    PHYSIO THERAPY MEDICINE 600.00
    INVESTIGATION CHARGES
    BIOCHEMISTRY 2,050.00
    CARDIOLOGY 8,000.00
    HOSPITAL SERVICES 13,600.00
    HOSPITALITY SERVICES 560.00
    MICROBIOLOGY 1,200.00
    MRI 4,000.00
    PATHOLOGY 1,730.00
    RADIOLOGY 1,400.00
    X-RAY 200.00
    IP PHAMACY CHARGES
    PHARMACY CHARGES 374.10
    IP PHARMACY CHARGES
    PHARMACY CHARGES 23,047.53

    Total Amount 61981.63


    Over all Disscount (0.00) % 0.00
    Final Amount: 61982.00

    Rupees sixty-one thousand nine hundred eighty-two Only (rounded value)

    List of Documents Enclosed


    > Original bills with day wise split-up.
    > Original discharge summary.
    > Medical card Xerox of the member/Patient.
    > Medical Card Verification sheet
    > Copies of Permitted Estimated by O/o CMO
    > Bill Summary covering letter generated from Online web Portal.
    > Xerox Copy of DD paid to the company by the member.
    > Invoices for stents/screws/ plates / devices used if any /costly injections & medicines amounting more than Rs.1000/ etc.
    > Other Documents Required cad-unstable angina
    > Copy of Aadhaar Card

    Authorised Signatory
    SUNSHINE HOSPITAL KARIMNAGAR , COURT CHOWRASTHA, KARIMNAGAR
    SCCL VENDOR CODE 2000025279

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