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The document is a patient bill for Mr. Sundaresan who was admitted to the hospital on September 24, 2020. It lists charges for pharmacy items, services, treatments, and lab tests during his stay totaling Rs. 46,680.20. Major charges include ambulance fees, CT scan, oxygen therapy, and various blood tests and diagnostics. The bill covers a period of over two weeks during which the patient received inpatient care and treatment in the ICU.

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skamalakannan1981
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192 views4 pages

Print Report

The document is a patient bill for Mr. Sundaresan who was admitted to the hospital on September 24, 2020. It lists charges for pharmacy items, services, treatments, and lab tests during his stay totaling Rs. 46,680.20. Major charges include ambulance fees, CT scan, oxygen therapy, and various blood tests and diagnostics. The bill covers a period of over two weeks during which the patient received inpatient care and treatment in the ICU.

Uploaded by

skamalakannan1981
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Mobile No :, . Email :minthospitals@gmail.

com
PAN NO:AAKCM6077A / TAN NO:CHEM17453C / CIN NO:U74999TN2016PTC112873

Patient Bill
Patient ID : 190900139 Address : 69,1 ST AVE , Admit Date : 24/09/2020 11:30AM
ADAYAR,CHENNAI , 600020
Patient Name : Mr.SUNDARESAN Dis.Date :
TAMIL NADU,INDIA
Age/Sex : 75/Male Ward Type : ICU

Mobile / Phone No : 7338777333 / Ward No :1

Consultant Name : MH,HOSPITAL IP Bill No : IP/136/2020-21

Payment Type : Cash

Patient ID : 190900139 Patient Name : Mr.SUNDARESAN Admit Date : 24/09/2020

Date Service Amount


GENERAL
26/09/2020 PHARMACY CHARGES 395.00
Day Total 395.00
27/09/2020 PHARMACY CHARGES 59.00
27/09/2020 PHARMACY CHARGES 213.00
27/09/2020 PHARMACY CHARGES 475.00
Day Total 747.00
29/09/2020 PHARMACY CHARGES 1425.40
Day Total 1425.40
30/09/2020 PHARMACY CHARGES 236.00
30/09/2020 PHARMACY CHARGES 671.00
Day Total 907.00
03/10/2020 PHARMACY CHARGES 975.80
Day Total 975.80
04/10/2020 PHARMACY CHARGES 230.00
Day Total 230.00

GENERAL Total : 4680.20

SERVICES
24/09/2020 AMBULANCE CHARGE 6500.00
04/10/2020 AMBULANCE CHARGE 2500.00

SERVICES Total : 9000.00

TREATMENT CHARGES
24/09/2020 CT CHEST 7500.00
25/09/2020 OXYGEN CHARGES 2500.00
26/09/2020 OXYGEN CHARGES 2500.00
27/09/2020 OXYGEN CHARGES 2500.00
28/09/2020 OXYGEN CHARGES 2500.00
29/09/2020 OXYGEN CHARGES 2500.00
Patient ID : 190900139 Patient Name : Mr.SUNDARESAN Admit Date : 24/09/2020

Date Service Amount

30/09/2020 OXYGEN CHARGES 2500.00

TREATMENT CHARGES Total : 22500.00

LAB
24/09/2020 PRO BNP 4000.00
24/09/2020 I L6 4000.00
24/09/2020 D - DIMER 1750.00
24/09/2020 LDH - SERUM 450.00
24/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
24/09/2020 RENAL FUNCTION TEST ( RFT ) 400.00
24/09/2020 LIVER FUNCTION TEST ( LFT ) 750.00
24/09/2020 PROTHROMBIN TIME ( PT ) 350.00
24/09/2020 HBA1C 500.00
24/09/2020 ACTIVATED PARTIAL THROMBOPLASTIN ( APTT ) 350.00
24/09/2020 CRP (C.REACTIVE PROTEIN) 350.00
24/09/2020 QBC MP 200.00
24/09/2020 DENGUE ANTIBODY 900.00
24/09/2020 SCRUB TYPHUS IGM 1500.00
24/09/2020 WIDAL 200.00
Day Total 16200.00
25/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
25/09/2020 ELECTROLYTES 450.00
25/09/2020 FREE THYROID PROFILE 850.00
Day Total 1800.00
26/09/2020 PROTHROMBIN TIME ( PT ) 350.00
26/09/2020 ACTIVATED PARTIAL THROMBOPLASTIN ( APTT ) 350.00
26/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
26/09/2020 ELECTROLYTES 450.00
26/09/2020 URINE CULTURE 400.00
26/09/2020 BLOOD CULTURE / SENSITIVITY 900.00
Day Total 2950.00
27/09/2020 AMMONIA 800.00
27/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
27/09/2020 LIVER FUNCTION TEST ( LFT ) 750.00
27/09/2020 ELECTROLYTES 450.00
27/09/2020 RENAL FUNCTION TEST ( RFT ) 400.00
Day Total 2900.00
28/09/2020 RENAL FUNCTION TEST ( RFT ) 400.00
28/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
Day Total 900.00
29/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
29/09/2020 LIVER FUNCTION TEST ( LFT ) 750.00
Day Total 1250.00
30/09/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
Patient ID : 190900139 Patient Name : Mr.SUNDARESAN Admit Date : 24/09/2020

Date Service Amount

30/09/2020 RENAL FUNCTION TEST ( RFT ) 400.00


30/09/2020 CORD BLOOD GROUPING & RH TYPING 150.00
30/09/2020 COVID 19 (PCR) 3000.00
Day Total 4050.00
01/10/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
01/10/2020 RENAL FUNCTION TEST ( RFT ) 400.00
01/10/2020 ARTERIAL BLOOD GAS 750.00
01/10/2020 ELECTROLYTES 450.00
01/10/2020 PRO BNP 4000.00
01/10/2020 D - DIMER 1750.00
01/10/2020 I L6 4000.00
01/10/2020 IRON 450.00
01/10/2020 FERITTIN 750.00
01/10/2020 TIBC-TOTAL PROTEIN BINDING CAPACITY 350.00
01/10/2020 SR.DIGOXCIN 2000.00
Day Total 15400.00
02/10/2020 ELECTROLYTES 450.00
02/10/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
02/10/2020 RENAL FUNCTION TEST ( RFT ) 400.00
Day Total 1350.00
03/10/2020 PRO BNP 4000.00
03/10/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
03/10/2020 ELECTROLYTES 450.00
03/10/2020 RENAL FUNCTION TEST ( RFT ) 400.00
03/10/2020 FERITTIN 750.00
03/10/2020 D - DIMER 1750.00
03/10/2020 I L6 4000.00
03/10/2020 COVID ANTIBODY IGG 1200.00
03/10/2020 COVID 19 (PCR) 3000.00
03/10/2020 MEGNICIUM ( ME+ ) 800.00
Day Total 16850.00
04/10/2020 COMPLETE BLOOD COUNT ( CBC ) 500.00
04/10/2020 RENAL FUNCTION TEST ( RFT ) 400.00
04/10/2020 ELECTROLYTES 450.00
Day Total 1350.00

LAB Total : 65000.00

XRAY
24/09/2020 X RAY CHEST AP VIEW 400.00
Day Total 400.00

XRAY Total : 400.00

ULTRASOUND
Patient ID : 190900139 Patient Name : Mr.SUNDARESAN Admit Date : 24/09/2020

Date Service Amount

25/09/2020 ECHO 2500.00


Day Total 2500.00

ULTRASOUND Total : 2500.00

IP CONSULTATION
24/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 5000.00
25/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
26/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
27/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
28/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
29/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
30/09/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
01/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
02/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 5000.00
02/10/2020 Dr. PRADEEP NAIR CARDIOLOGIST 2500.00
03/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00
04/10/2020 Dr. CONSULTANT GENERAL PHYSICIAN 10000.00

IP CONSULTATION Total : 102500.00

PHARMACY
24/09/2020 PHARMACY CHARGES 4759.00
25/09/2020 PHARMACY CHARGES 20138.00
26/09/2020 PHARMACY CHARGES 17243.00
27/09/2020 PHARMACY CHARGES 8825.00
28/09/2020 PHARMACY CHARGES 16591.00
29/09/2020 PHARMACY CHARGES 7502.00
30/09/2020 PHARMACY CHARGES 8126.00
01/10/2020 PHARMACY CHARGES 4442.00
02/10/2020 PHARMACY CHARGES 5060.00
03/10/2020 PHARMACY CHARGES 4699.00
04/10/2020 PHARMACY CHARGES 12411.00

PHARMACY Total : 109796.00

Total : 316376.20

Discount : 0.00

Rounded Off : -0.20

Total : 316376.00
Amount to be Received : 316376.00

Bill Prepared by : SELVI

Bill Checked by :
Authorized Signatory

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