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Dengue Ns1 Antigen Test (Elisa/Elfa) - 600.00 0.00: Duplicate

This bill of supply from QRG Medicare Ltd is for a dengue NS1 antigen test performed on Mrs. Ritu Goel. The test cost Rs. 600 which was paid in cash by the patient. Central Govt. Health Scheme is listed as the payer and sponsor. The test was performed on August 9, 2023 at QRG Hospital. The bill provides details of the test, patient, payment received, and contact information for the hospital.

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Abhishek Goel
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259 views1 page

Dengue Ns1 Antigen Test (Elisa/Elfa) - 600.00 0.00: Duplicate

This bill of supply from QRG Medicare Ltd is for a dengue NS1 antigen test performed on Mrs. Ritu Goel. The test cost Rs. 600 which was paid in cash by the patient. Central Govt. Health Scheme is listed as the payer and sponsor. The test was performed on August 9, 2023 at QRG Hospital. The bill provides details of the test, patient, payment received, and contact information for the hospital.

Uploaded by

Abhishek Goel
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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QRG MEDICARE LTD. PAN No.

: AAACQ2238D
Plot No - 01, Sector 16,Faridabad-121002 Haryana- GST No. : 06AAACQ2238D1ZW
Tel: 91-129-4330000 Fax: 0129-4330033
E-mail: [email protected] Website: www.qrghospital.com

*200110642*
Duplicate BILL OF SUPPLY Cum Receipt

Bill No : QHOC24/57895 BillDateTime : 09/08/2023 10:21AM


UHID : 200110642 Payer : CENTRAL GOVT. HEALTH SCHEME -Cash
PatientName : Mrs. RITU GOEL Payer Address : CGHS FARIDABAD Haryana
Gender/Age : Female/30 Yr 11 Mth 6 Days Payer GSTIN :
Patient PAN : Sponsor : CENTRAL GOVT. HEALTH SCHEME -Cash
Address : H.NO-1094 SECTOR 19 , FARIDABAD, Presc. Doctor : Dr. Santosh Kumar Agrawal
Haryana, INDIA, - 121002
Lab No : 1920130
Refered By : Self
App. Date :
Contact No : 9728400485
1

SN SAC Particulars Rate Unit Total Disc. Net Amt. Pat. Amt. Payer Amt.
1. Dengue Ns1 Antigen Test 600.00 1.00 600.00 0.00 600.00 600.00 0.00
(ELISA/ELFA).
Gross Amount : 600.00
Discount (-) : 0.00
Net Amount : 600.00
Payer Amount : 0.00
Patient Amount : 600.00
Amt Received : 600.00
(INR)
Balance Amt. : 0.00

By Cash: 600.00 ,
Amount Received in words (Rs ) Six Hundred Only.
Narration :
Authorised Signatory

* No cancellation will be done next day/later. Validity of consultation is (2) working days
* For free home sample collection pls. call at: 7835003879 (8AM-8PM) * for any assistance kindly contact 7835003875
* You may download patient app “Marengo Asia Hospitals App” using the link https://patientapp.marengoasia.com/download.html
* For Home delivery of medicine please call at: 7835005558
*Kindly collect all investigations(Pathology & Radiology) reports from PHC dept. in room no. 2003.

Printed By: Prepared By: 37140 Printed Date: 09/08/2023 (1/1)

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