APOLLO HOSPITALS
EMERGENCY
1066
Opposite IIMB,154/11, Amalodbhavi Nagar, Panduranga Nagar, Bangalore - 560076 (India) Tel.: +(91)-80-26304050 / 26304051 Fax: +(91)-80-41463151
INPATIENT BILL PATIENT DETAILS
IP No. : 97101
ID No. : 0000246611
Saravana kumar V
Bill No. : ICR33504
A2 Nagesan nagar Vadalur Cuddalore taluk TamilNadu
Bill Dt./Time : 13-Jan-2013 10:06 AM Admission Dt./Time : 10-Jan-2014 7:22 AM Discahrge Dt./Time : 13-Jan-2014 10:06 AM
DETAILS Service Name
Amount(Rs.)
ROOM RENT PHARMACY MEDICAL EQUIPMENT CONSULTATIONS CONSUMABLES INVESTIGATIONS
4,000.00 2,765.54 1,000.00 2,400.00 2,118.00 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 Receipt 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 enquiries, please mail:
[email protected] [email protected] © Apollo Hospitals, Bangalore 2013, All Rights reserved
