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Fortis

The document is an outpatient bill from Fortis Hospital, Noida for a consultation with Dr. Anjana Singh, totaling 1,200.00 INR. The patient, Ms. Shraddha, is advised to follow prescribed medications for three months. Payment was made in full via PayU Collection on March 29, 2025.

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Kitty Tyagi
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309 views1 page

Fortis

The document is an outpatient bill from Fortis Hospital, Noida for a consultation with Dr. Anjana Singh, totaling 1,200.00 INR. The patient, Ms. Shraddha, is advised to follow prescribed medications for three months. Payment was made in full via PayU Collection on March 29, 2025.

Uploaded by

Kitty Tyagi
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

Fortis Hospital, Noida

Fortis Hospital,B-22,Sector-62, Noida-201301, U.P.(India)


UPI Scan
Tel: 01202400444 |Fax: NA
Emergency: 0120 4300222 |Ambulance: 9009001050 & Pay
Email: [email protected] |Website: www.fortishealthcare.com

GST No. : 09AABCF3718N3ZA

OUT PATIENT BILL


Name : Ms. Shraddha Primary Doctor : Dr. Anjana Singh
UHID : 13756321 Referring Doctor : NA
Contact No. : 9999658417 Payor Name : NA
Age/Sex : 26 YEAR(S)/Female Payor Site Name : NA

Episode No. : 68810/25/1104 Discount Scheme : NA


Bill Date : 29-Mar-2025 11:36 AM Insurance : NA
Print Date : 29-Mar-2025 1:09 PM TPA : 0.00
Patient Address : D1-308, Gardenia Gateway, Plot No. 9, Sector- CIN No : U93000DL2009PLC22216
75, Noida - 201304
Employer Name : NA

BILL NUMBER BILL TYPE BILL DATE BILL AMOUNT


110425OPCS070148 CASH 29-Mar-2025 11:36 AM 1,200.00

S.No Particulars Accession No HSN Code Qty Service Amount Contractual Discount Net Gross Amount
1 CONSULTATION-Anjana 999312 1.00 1,200.00 0.00 1,200.00
Singh (Gynaecology)
TOTAL AMOUNT 1,200.00 0.00 1,200.00

BILL AMOUNT 1,200.00

PATIENT SHARE 1,200.00


PAID BY PATIENT 1,200.00
NET PATIENT PAYABLE 1,200.00
BILL ROUND OFF AMOUNT 1,200.00

Rupees In Words: Rupees One Thousand Two Hundred only

Prescribed Medicines:
1. Spironolactone
2. Ginette 35
Note: Follow these medicines for 3 months.

Manager
Prepared By: MyFortis Platform Cashier

Note: Collect reports / films within 90 days of test. After 90 days hard copy available on chargeable basis only
Receipt Detail

S.No Receipt No. Receipt Date Amount Balance Amount Payment Mode
1 1104/DP/2503/78279 29-Mar-2025 1:35 PM 1,200.00 0.00 PayU Collection

Regd. Office: A Unit of Fortis Hospitals Limited, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi - 110025 (India)
Tel: +91-11-26825000 Fax: +91-11-41628435 CIN: U93000DL2009PLC222166
Note: This is a computer generated invoice. No signature is required.

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