Lohchab Nursing Home Slip
Lohchab Nursing Home Slip
Lohchab Nursing Home Slip
A center for Infertility & Maternity care with Facility of Laparoscopy, Hysteroscopy, Sonography & Color Doppler
Signature
LOHCHAB ULTRASOUND & X-RAY CENTER RAMGHAT ROAD, ALIGARH-202 001 PH: 2742755, 2743955
A center for Infertility & Maternity care with Facility of Laparoscopy, Hysteroscopy, Sonography & Color Doppler
Signature
LOHCHAB ULTRASOUND & X-RAY CENTER RAMGHAT ROAD, ALIGARH-202 001 PH: 2742755, 2743955
A center for Infertility & Maternity care with Facility of Laparoscopy, Hysteroscopy, Sonography & Color Doppler
No Dated:......................
Signature
LOHCHAB NURSING HOME
RAMGHAT ROAD, ALIGARH-202 001 PH: 2743755
Patients Mr./Mrs...............................................................................................................
W/o ..................................................................................................................................
Address ............................................................................................................................
..........................................................................................................................................
D.O.A............................................D.O.D.....................................Bed No.......................
Total Days .........................................................................Adm.No................................
Amount
Sl. PARTICULARS
Rs. P.
1. Admission Charges
2. Room Rent
3. Specialist Charges
4. Physician
5. Delivery/Operation Fee
6. O.T. Charge
7. Aneasthetist
8. Asst. Charge
9. Paediatrician Charge
10. I.V./Blood Transformation
11. Nursing Care
12. Dressings
13. Oxygen
14. Dr's Visit
15. C.T.G.
16. Misc.
Advance Total
Total Rupees.........................................................................................................
Received with thanks ...........................................................................................
E.&.O.E. Signature