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DEPTT. OF RADIOLOGY & RAl)IOTHERAPHY

X-RAY FORM
Nam~ ...f.c0tlt.~.~······;······:······ Ag~ .?.~ Sex~
.Wai-d ____ f -~ -~----- Bed No ___ --·---·--···· O.P. D. No~ ..t-~
·Brief Clinica~ Notes & Prov. •piag... f.~.~ .. ...
P~ ·to be radiographed.... ~ --........................ .
M.I. (For medioeg, t _c~~s only)- .,.
- ..
F.or/ Paid .......................... :;.... Signature .of M.O. I/ C
Sanction of the Superintend~nt.

REPORT: 7l . . ' , •.
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I . .,1t~ospital Uttarkashi,U

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District Hospital Uttarkashi, D1stn '

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Y-o~~~rtme~t: General OPD Registrafi
. ''l:. . J.. . •.
: N-ame.:· PAIWATI - -~ · ' ·Father/Hu and N'ame: MR ..
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a r(,s) .;, • ., Gender : eroale \
l~:ategory,; APC-::-.. 1
Date...: 03'" 4/2_0·.·L..ij
Date History/Complaints :

Examination:

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r,,~l\1 ~r..,Q!~1J~J 09:49:29
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 GST INVO ICE

Nllll\!Li\L ASllll A1\1 ElOSPJTA L ME JJICAI.1 ST ORE

GST NO . ·. 05AAATN3225MZ8 MAYAKU ND ,RISH IKESH . Phone : 01 35 -2430142,2432215
DL No . ·. UA-DEH-1 1 \ 488 & Ui\-DEH-1114 89 3DE HRADUN UTT ARAKHAN D-24SJ201

Partv .Name: BEAZ PARWATI Dr Name: Invoice No. A007346

Patient Name : PARWATI
CASH Dale 11/04/2023
Patient Phone: 0
SNo. \ PRODUCT NAME 1
Pack HSN BATCH EXP. QTY. M.R.P. O/S% 1 Amount
1 \ CALPOL-650+ TAB 1' 15TAB 1•151 I 3004 E/\ 102 11 /24 2 34.00 5. 00 4.53
2 PANTDOT-E INJ 1*1VIAL I 1·1v1 3004 SDG-33B 10/24 2 175.00
3 I
GENTICYN-80 INJ 1*2ML 1•2ML 3004 AI-IH0211 6/24 2 10.44
10. 00
5.00
350.00
20.88
4 ! SUPACEF-1 .5 INJ 1*1.5GM 1*1 .5 3004 2020E2 4/24 2 4 17.65 7.00 835 .30
5 1 DISPO-VAN 10ML 1*1PAK 1*1PA 9018 250103JY 11 /2 7 I 1 10.00 30.00 10.09
6 DISPO-VAN SML 1*1PAK 1*1PA 9018 245055NC 10/27 1 8.50 30.00 8.50
7 I DIS PO. NEEDLE 18X3/2 1 ' 1APK 1*1AP , 9018 40244P 8/27 ' 2 2.50 5.00 5.00

SUB TOTAL 1234.21

Discount 100.54
..,,~~na ·, ·~ SGST 6 °,o 60.74
All Disputes Subject To Rishikesh Jurisdiction Only.
Goods Can Be Returned Under 15 Days Only.
For NIRMAL AS ffiR:A!M t:N~P, . '·- ·El1~C'A_LGSTORE CGST 6 % 60 .74
•: · ,_ ,, . . ,oc,,\ l49l. Roun doff 0.33
Nithout Bill Goods Cannol Be Returned. . -: l) 1•"':. \. I -
,., \''.\ 1-:1:, :\, \,'
Authoris ed Signatory
-
s. One Thousand One Hun dred Thi rty Four Onl y GRAND TOTAL 1134.00
 GST INVOICE

~~lRNlAL ASHRAM HOSPITAL MEDICAL STORE

GST NO .: li5t\AA1N3225A1ZB MAYAKUND,RISHIKESH , Phone : 0135-2430142,2432215
DL No . :UA-DEH-'\'\ 1488 & UA-DEH-111489 3DEHRADUN UTT ARAKHAND-249201

Partv .,Name : BEAZ PA.RWATI Dr Name : Invoice No. A005280

)
Patient Name: PARWA1 \
Patient Phone: 0 CASH Date 08/04/2023

SNo.\ PRODUCT NAME ! Pack I HSN I

I I
BATCH EXP. / QTY.1 M.R.P. DIS% Amount
1 '' GEN11CYN-80 INJ 1*2ML 1 1*2ML I 3004 ' AHHO211 6/24 3 10.44 5.00 31 .32
2 \ DICLOGESIC-RR INJ 1*1 AMP \ 1*1AM WHN1J003 i 9/24 3 56.75 / 5.00 170.25
3 !SUPACEF-1 .5 INJ 1*1.5GM 1*1.5 3004 2018E2 4/24 2 417.65 7.00 835.30
4 ' PAN1DOT-E INJ 1•1VIAL \ 1*1VI 3004 SDG-33B 10/24 2 I
175.00 10.00 I 350.00
5 DISPO-VAN 10ML 1' 1PAK
6 '1 DISPO. NEEDLE 18X3/2 1*1APK
1*1PA 9018 250103JY 11/27 3 I 10.00 1 30.00 I 30.00
I 1*1AP 9018 40244P 8/27 3 I 2.50 5.00 7.50
7 , NS-~00ML IN 1*100ML I 1*100 3004 82011686 11/25 1 19.65 5.00 I 19.65
I
8 DISPO-VAN 5ML 1*1PAK 1 1*1PA 9018 245055NC 10/27 2 8.50 30.00 17.00
9 1 EXAMINATION GLOVES 1 "1PCS 1*1PC 4015 SH220855 7/25 10 8.00 5.00 80.00

SUB TOTAL 1541 .02

Discount 123.01
SGST 6 % 75.97
All Disputes Subject To Risl!ikesh Jurisdiction Only. CGST 6 % 75.97
Foe NIRMAL ASHRAM HOSP~ ~; ORE
Goods Can Be Returned Under 15 Days Only. Roundoff 0 .01
Withuut Bill Goods Cannot Be Relurncd.
Authorised Signatory
-- - -

Rs . One Thousand Four Hundred Eighteen Onl y GRAND TOTAL 1418.00

 GST INVOICE

NlRMAL ASHRAM HOSPITAL MEDICAL STORE

GST NO . : 05AAATN3225A1ZB MAYAKUND ,RISHIKESH, Phone : 0135-2430142,2432215
DL No. :UA-DEH-111488 & UA-DEH-111489 3DEHRADUN UTTARAKHAND-249201
Party Name: PARWATI Dr Name :
Patient Name : PARWATI
I
Invoice No. A005297
Patient Phone: CASH Date 08/04/2023
SNo.', PRODUCT NAME Pack HSN BATCH
1 EXP. I QTY. M.R.P. / DIS% Amount
ONS-500ML IN 1*500ML I 1*500 3004 1229630 11/25 38,42 20.00 38.42
2 I 0-5% 500ML 1 '500ML 1'500 3004 1228044 10/25 1 38.00 20.00
' 38.00

SUBTOTAL 76.41
Discount 20 % 15.28
All Disputes Subject To Rishikesh Jurisdiction Only. I SGST6 % 3 .28
For NIRMAL ASH_R AM HOSPITAL CGST6 % 3 .28
Goods Can Be Returned Under 15 Days Only.
Roundoff 0.14
Without Bill Goods Cannot Be Returned.

Authorised Signatory

Rs. Sixty One Only I GRAND TOTAL 61 .00

 II
GST INVOICE

GST NO. :
05
AAA~~~~L

1--D_L_N_o_._:u_A_-o_E_H_-_
11_1_48_8_&_u_ A
ASHRA~!!A?u~~~s!!~. MEDICAL STORE
_-_o_E_
H-_1_11_4_8_9 _ _3_D_E_H_R_A_o_u _N_u_n_ A
_R
Phone : 0135-2430142,2432215
_A_K_H_A_N_D_-2_4_9_20_1_ _ _ _ _ _ _ __ _ _ _ __ _,
Party Name :
Patient Name : parwati
Patient Phone:
parwati
1 Dr Name :
CASH
I Invoice No.
Date
A003927
06/04/2023 1
SNo. \ PRODUCT NAME 1 Pack
I HSN BATCH EXP. QTY, M.R.P. Amount
I I DIS¾ /
1 \ CALPOL-650 TAB 1'15TAB
2 PANTDOT-L CAP 1'10CAP
1 1'15T
1 1·1oc
3004
3004
i EA101 I 11/24
GC3026B I 11/24
I 5
3
I
34.07
I

270.00 '
s.oo
10.00
I
I
11.36
81 .00
3 ULTRACET-SEMI TAB 1'15TAB. • 1' 15T 3004 J12010 I 11/24 I 9 146.00 5.00 87.60
4 TUDOR-FORTE TAB 1'10TAB I 1*10T 3004 i LGL 11/15 I 4/24 I 6
I
360.00 7.oo I 216.00
I
5 LIZOKEF-600 TAB 1'10TAB 1*10T 1901 KLE2208B 6/25 6 356.00 5.00 213.60
I
I
I I
I
I I
I I I
I '
I ' II
I II
I
I I
I

I I
I
I
I
'
SUB TOTAL 609.56
Discount 38.85
All Disputes Subject To Rishikesh Jurisdiction Only. SGST6% 30.58
Foe NIRMAL ASHRAM H~S~ ~L 'STORE : CGST6% 30.58
Goods Can Be Returned Under 15 Days Only.
Roundoff 0.29
Without Bi// Goods Cannot Be Returned.

Aµthorised'Signatory
... J
- - - - - r 1
J .,
1l-
---- - -- - - - -
j Rs. Five Hundred Seventy One Only GRAND TOTAL 571 .00
 GST INVOICE

8 8
1-g-~_:_~o_:u_~_~;-~_/_~_~_!t _~s-M:
_~z_;_D_~---~-'_48_~_R
_ :_DE_~_RM_/_
! _t_K~-~_;_,:_;_;_t_~_t_~2-~_92_0E
_1-D------,Ic_ Ph_~_ne_ _oT
-13_?_24_~_0_14_2._24_3_22_1_5 _ - ; /

I
A_

Party Name:
Patient Name : MS PARWATI
MS PARWATI Dr Name :
I Invoice No. A002623
I Date 04/04/2023
Patient Phone: CASH
r - - - -- - - - - - , - - - - - - - - - - - - , - - - - - - - - - - . - - - - - . - - - - - 1
SNo. , PRODUCT NAME . Pack I HSN
I BATCH EXP.
1
QTY : M.R.P.
i D1S% i' Amount
1 , LIZOKEF-600TAB1*10TAB 1•10T I 1901
I KLE2208B 6/25 ' 4 356.00 5.oo I 142.40
I I
2 I TUDOR-FORTETAB1*10TAB 1•10T 3004 LGL11/15 4/24 6 360.00 7 00 ' 216.00
I
I
1
3 ULTRACET-SEMITAB1 . 15TAB. 1•15T I 3004 J12010 11/24 6 146.00 5.00 , 58.40
I I
4 [ PANTDOT-L CAP 1*10CAP 1·1oc I 3004 GC3026B 11/24 2 270.00 10.00 54 .00
I CALPOL-650 TAB 1*1 5TAB , 1•15T I 3004 ·'
5 EA101 11/24
I 4
I
34 .07 1 5.00 I 9.09
I I
'
I '

I
I
""
'
. I
i I
i
I I
I I I
SUB TOTAL 479.89
Discount 31 .01
' SGST 6 % 24 .04
All Disputes Subject To Rishikesh Jurisdiction Only.
Goods Can Be Returned Under 15 Days Only. Foe NIRMAL ASHRAM HOSPITA~ ~~ E I
CGST 6 % 24.04
Roundoff 0 .12
Without Bill Goods Cannot Be Returned. I
I
Auttiorised Signatory I
I
-
Rs. Four Hundred Forty Nine Only I GRAND TOTAL 449 .00
 GST INVOICE

NIRMAL ASHRAM HOSPITAL MEDICAL STORE

GST NO.: 05AAATN3225A1ZB MAYAKUND,RISHIKESH , Phone: 0135-2430142,2432215
DL No . :UA-DEH-111488 & UA-DEH-111489 3DEHRADUN UTTARAKHAND-249201

Partv ,Name: BEAZ PARWATI Dr Name :

I Invoice No . A004780
Patient Name : PARWATI
Patient Phone: 0 CASH Date 07/04/2023

SNo. \ PRODUCT NAME Pack HSN BATCH EXP. I QTY. M.R.P. DIS% Amount
1 1 TRIMMER RAZOR 1*1 PCS
2
3
I EXAMINATION GLOVES 1*1PCS
CX-S 1.5 INJ 1*1 INJ
1"1PC
· 1*1PC
OTHE
4015
G2212100
SH220855
11/27
7/25
2
6
37.00
8.00
10.00
5.00
74.00
48.00
1*11N 3004 822322A 7/24 2 275.00 10.00 I 550.00
4 \ PANTDOT-E INJ 1*1VIAL 1*1VI 3004' SDG-338 10/24 2 175.00 10.00 350.00
5 I CANNULA-BO 20NO . 1*PCS 1*PCS 9018 2334023 11/27 283.50 I 70.00 I 283.50
6 CANNULA FIXER TAPE 1*1 PCS 1*1PC 3004 1S006322 8/27 1 75.00 1 53.00 I 75.00
7 i DISPO-VAN 10ML 1*1PAK
8
9
I DISPO-VAN 5ML 1"1PAK
DISPO. NEEDLE 18X3i 2 1*1APK
1*1PA
1"1PA
1 1*1AP
9018
9018
250103JY
245055NC
11/27
10/27
2
2
10.00 I
8.50
30.00
30.00
20.00
17.00
9018 40244P 8/27 2 2.50 5.00 5.00
II I
I
I
I
SUB TOTAL 1422.50
Discount 349.35

'
SGST6 % 57 .50
All Disputes Subject To Rishikesh Jurisdiction Only.
Goods Can Be Returned Under 15 Days Only.
For NIRMAL ASHRAM HOSP! I&RE CGST6%
Roundoff
57 .50
0 .15
Without Bill Goods Cannot Be Returned. ,, r ,. .;\1iJ.,
\.. \
\ \ ..
\,,, J

Authorised Signatory

Rs. One Thousand Seventy Three Only GRAND TOTAL 1073.00

 GST INVOIC E

NlRIVIAL AS H.RAM HOSPlT AL MEDICAL ST{) RE

GST NO. : 05AAATN3225A1 ZB MAYAKUND,RI SHIKESH, Phone : 01 35-24301 42,243221 5
DL No . :U A-DEH-111488 & UA-DEH-111489 3DEHRADU N UTT ARAKHAN D-24920 1

Party Name : PARW ATl Dr Name: I

Invoice No. A007472
Patient Name : PARWATI
CAS H Da te 11 /04/2023
Patient Phone:
SNo. PRODU CT N_AiVI E Pack HS N BATC H EXP. QTY. M.R.P. DIS% Amount
1
1 P/\NTDOT-L C/\P 1*1 0C/\P 1·1oc 3004 GC3026B 11/24 10 2 70.00 I0.00 270.00
2 LIMCEE TAB 1"1 5TALl 1•15T 3004 Ll /\230 17 I 6/24 10 25.53 5.00 17.02
3 DEBRILY SE-PLU S TAB 1 ' 10TAB 1•10T 3004 KlcH 2220B 6/25 20 281 .50 5.00 563. 00
4 \ DALAC\N -'C 1 50 CAP 1•10CAP 1·1 oc 3004 B652303 7/2G 30 164 .57 5.00
I
493 .71

SU B\T OT AL
•. ,,.\ Discoun\
All D,spules Subject To Rishikesh Jurisdiction Only. • SGST
Goods Can Be Returned Under 15 Days Only. Fo, Nli1MAL ASH RAM HOSl'ITAL MEDICAL ST ORE ' '\
Without Bi/I Goods Cannot Be Returned.

I
Rs . One Thous and Two Hundred Six ty Three Onl y
Authori sed Signat o ~
_..,,• .
-~

GRAND TOTAL '\263.00

 C\~~11
1990
NIR.1VrA.L ASHRAM HOSPITALEstb-
Phones ... 0135-24 Mayak und Rishikesh (Dehradun) Uttarakhand ) 2430 142
30942 , 2439551, 2439552, 2439553, 2439554, Fax:(+ 135
e-mail : [email protected]
Reee· N _ (A Unito-:.!R~·~J;IJ[l].Cm'..::,:._:R_:/:s:..:,hl::,:k:e:sh~~~,--x-::-:;;--;P;-;;ri:;::n:::;-te_d_ O_n_ __
'Pt No : AH/Receip~ pril, 2023
OPDNo NAH/Opo • 4/5053
. /2023/41 UHID NAH/2023/201431
Narne . Ms PARVV 006
Ref. : -
· ATI
NAHtQp
Date : 17/4/2023
Sr:filo --- -- D12023141006
Age I Sex : 30/ F
~ articuJar-
1 - - o --- - - - -
Mino~ ressing • -
in OT - .
Rate Unit servamt:
~10=-=o=---- -1- -
100
remarks: Total : Rs. 1oo

We do not just check

uls~~ not only
-
-~he.ci<"frie"p"ulse··oun~ yo.......heanvve t . - - - -=-
. ur
ouch Your heart-
 GSTINVOICE

NIRMAL ASHRAM HOSPITAL MEDICAL STORE

GST NO .: 05AAATN3225A1ZB
DL No. :UA-DEH-111488 & UA-DEH-111489
MAYAKUND ,RISHIKESH,
3DEHRADUN UTTARAKHAND-249201

•
Phone : 0135-2430142,2432215
Ii
I
Party Name : CASH Dr Name : Invoice No. A011085
Patient Name : Date
CASH 17/04/2023
Patient Phone:
SNo. PRODUCT NAME Pack HSN BATCH EXP. QTY M.R.P. / DIS% Amount
1 ARM SILING POUCH-FT 1*1PCS 1*1PC 9021 AS02 1 30.00 400.00
400.00 1

I
I
I SUB TOTAL
\
400.00
SchemeNolume Discount 18.00
All Disputes Subject To Rishikesh Jurisdiction Only. Discount 30 % 114.60
Goods Can Be Returned Under 15 Days Only. For NIRMAL ASHRAM HOSPITAL MEDICAL STORE SGST2 .5 % 6.37
Without Bill Goods Cannot Be Returned. CGST2.5% 6 .37
Roundoff 0.40
Authorised S ignatory
I Rs. Two Hundred Sixty Seven Only
GRAND TOTAL 267 .00
 GST INVOICE

NIRMAL ASHRAM HOSPITAL MEDICAL STORE I

GST NO .: 05AAATN3225A'1ZB
lDL No. :UA-DEH-111 488 & UA-DEH-111489
MAYAKUND ,RISHI KESH,
3DEHRADUN UTTARAKHAND-249201
Phone : 0135-2430142,2432215

Party Name: AAL PARWATI

Patient Name : PARWATI l Dr Name : G.S.TNO.05AAJCS7141Q1ZS Invoice No. A006108
Patient Phone: 0 II , C~H I Date 09/04/2023 I
SNo. PRODUCT NAME \ Pack· I
HSN ' .....
I BATCH
I

1 SUPACEF-1 .5 INJ 1*1 .5GM

I
I
1*1 .5
'
3004 I
2020E2
EXP.
4/24 I
QTY. M.R.P.
2 417.65
DIS¾ ; Amount
I
2 GENTICYN-80 \NJ 1*2ML
3 : PANTDOT-E INJ 1'1VIAL
I
I 1*2ML
1·1vI
3004 I
I
AHH0211 6/24 ! 2 10.44
7.00
5.00
835.30
20.88
I
I
3004 SDG-33B 10/24 2 175.00
4 I DYNAPAR-AQ \NJ 1*3ML I 10.00 350.00
5 I.V.SET 1*PCS
6 : R.L-500ML IN 1*500ML
1*3ML
1*PCS
1*500
3004
9018
3004
'I 023S449
G2211205
8/24
10/27
I

I
1
1 I
33.50
176.00
5.00
75.00
33.50
176.00
I
2230502 12/25 I 1 56.42 20.00
7 I NS-100ML IN 1*100ML
8 I LORl-2ML(DIAZEPAM) 1*1AMP
1·100 3004 II 82011686 11/25 2 19.65 5.00
56.42
3004 I 39.30
11*1AM AND41002 9/23 I 1 14.00
9 / PENTAZOCINE \NJ 1 "1AMP I 5.00 14.00
1*1AM 3004 MHTl-003 1/24
10 r TRAMADOL-2ML \NJ 1*2ML ' 1 38.50 0.00 38.50
: 1*2ML OTHE 1 27762204 7/25 1
11 1 EMESET-2ML !NJ 1 '2ML 26.00 5.00 26.00
' 1*2ML 3004 S620075 8/25
12 1 DISPO-VAN 20ML 1*1PAK 1 14.53 5.00 14.53
1
13 0/SPO-VAN 10ML 1*1PAK
1*1PA I 9018 304201JG 12/27 I 2 25.00 10.00
1*1 PA 9018 50.00
250103JY 11/27 , 2 10.00
14 ! MAGNEX FORTE-1 .5 INJ 1 *1V/AL · 30.00 20.00
1*1VI 1901 2239146A 7/24
15 / H/NGLACT- 1NO HP23470 180 1*1 1 729.06 5.00 729.06
1*1 PC 9018 ·1 2300030 1/28
16 / H/LON 2-0 3336L 2-0 RIC 1*1 P 1 525.00 5.00 525.00
1*1PC 9018 S3622002 6/27 1
1- , "\~~\~J_\
170.00 5.00 I 170.00
Terms & Conditions
All Disputes Subject To Rishr~esh Jurisdiction Only. -,,q':\~ -_-, r. TOTAL C/F 2475 .12

r,1t~ mClr
Goods Can Be Returned Under 15 Days Only. ~-'' , ~·- J •·· r .•

w;1hout BUI Goods c'""" Be Rol"med For NI R MAL ASH R'li~ ',!·; STORE

Remark : , 1"\'J ,....y \

__ __ __ _ _ Autho1·ised_~i~na!o_ry
J
I
;::; I li , ;; JOP57 'l ::7'\".
 GST INVOICE Page No... 2

NlRMAL ASHRAM HOSPI1,AL MEDICAL STORE

JST NO.: 05AAATN3225A1ZB MAYAKUND,RISHIKESH,
DL No. :UA~DEH-111488 & UA-DEH-111489 Phone : 0135-2430142,2432215
1
3DEHRADUN UTTARAKHAND-249201
Party Name: AAL PARWATI I
. Patient Name: PARWATI Dr Name: G.S.TNO.05AAJCS7141Q1ZS Invoice No. A006108
Patient Phone: 0 CASH Date 09/04/2023
1 1
SNo. 1 PRODUCT NAME
I Pack HSN BATCH EXP. / QTY) M.R.P. DIS% / Amount
17 PYROLATE INJ 1*1ML TOTAL 8/F 2766.51
1*1ML
18 ATROPINE INJ 1*1ML
1*1ML
3004
3004
KP125408 9/25 1 I 14.00
1 5.00 I 14.00
19 CAP DISPO 1*1PCS KP35100 8/24 1 4.53 5.00 4.53
1

1*1PC 6217 CAP/1221

20 FACE MASK 1*1 PCS. 4 I 10.00 , s.oo I 40.00
1*1PC 6217 62103090
21 LEVO-ANAWIN-.5% 4ML 1'4ML
I 4 I 5.00 1 5.00 20.00
1*4ML
22 GLOVES-STERILE 1*1 PC
1*1PC
3004
4015
1983001
23A3024 I
2/24 1 I 108.00
1
5.00 I 108.00
12/27 8 80.00 50.00
I
640.00
I

I
. ;. ,
-1,:""J_,.'•' SUB TOTAL 3925.02
\ . ,··. ,. ·7' ,.,.. :. \..,. Discount 655.70
All Disputes Subject To Rishikesh Jurisdiction Only. r',.I.
SGST 173.30
Goods Can Be Returned Under 15 Days Only. For NIRMAL ASHRAM HO,SPI r\L ~E01CAL STORE CGST 173.30
\(_ I .
Without Bill Goods Cannot Be Returned. Roundoff 0.32
1
; i;-..i - Signatory

Rs. Three Thousand Two Hundred Sixty Nine Only -- G R

- AND T O-TAL -- 3269.00 I
X · C
 «=t~fdgJd l{Wfu"II

NIRMAL ASHRAM HOSPITAL ,

Mayakund, Rishik<;sh - 249 20 I , Distt- Dehradun (Utrarakband) India

Phone: 0135-2430942, 2439551 , 2439552, 2439553, 2439554 Fax : 0135-24301 42
WWW-nirmalhospitals_com email. : nah@nirmalhospicaJs_ co·m 2f / <if/ Jo2

A UNIT OF NIRMAL ASHRA

--:;:;,- OPERATION THEATRE CONSUMABLES
Name ( ~~------- --------- -- Bed No __________ ___ ____ _Age ___ 3_9)£ ___I. P: o_ No __l..C/f../J.. ___
S.No.
1_ Venflon Perinorm
2_ IVSet - c _ y
@
DW
3_ BT set LP ~eedle ._ !..,, /4n / o 'Mt
4_ Scalp Vein Syringes - <X.. o'Y'Y1 V
5_ Foley's /1 (._Q,()'VJ . Megapen
6_ Nelcath ,. _ ,,__(,..,A-.
7_ Feeding T Jl>L@t5~ FLZ.,,~p Genta

~{j)
Cipro
s_ Ryle's T e ;flo/i_- - - 0.), Metrogyl o
9_ Urobag ,e-:
p@)p(/!£}W- /;2
"\O _ Cord-cla ~:!~:one ~/"11
· -(/
v-/' c2--V_}¤; R(;)~
ffi
Baby Oil / . Prolene
S ~fra-tulle <::-- \...j() U
ABGEL _:) Vicryl
Op Site M e rsilk HtkJr>f'J.:::V) /1
'\4 .
Gly co- . V
'\5. Gypsona
Atropine \ (")
16.
17.
18_
Micropore
Bandage ~ - '\•
Romovac
A"".: ·
@ (!!JtiiY _
51 .
52.
Adrenaline
Efcarlin
U?- f - ~
r-/J,1nw --C. }.__.(v./J
19_ Corrugated drain 53. Skin Graft Blade '' //VV "l"> -
54.
-=--:c-
20. Dispo Van Aminophylline
21_ RI 55.
56.
Dopamine
v1J..O ~~f71CJ -
(j) ~'M2-
22-DNS Pentothal
23_ DXTRS l- -JI_ 57. Scoline
24. NS _ , / D,0
'M 58. Pavuulon
25. · Diazepam - l 59. Norcuron
G, }ovt<5 -- 1-j_ {!!)
@)
26. Fortwin - - \ 60 _ Ketmin
27. Synto 61 . f
(/(j)
Sensorcaine
28_ Methergin ° -, 1 62. Xylocanie .
29. Phenergan l11cJ / 63. Cotton
Y)d {!)
O
64. Metrogyf Oint
;~: ~~o~todin J
65. Betadine Oint
32. Botropase 66. Ortho
33. Revici 67 _ Catgut
68 .
 C\~~11
NIRMAL ASHRAM HOSPITAL Estb.1990
. Mayakund Rishikesh (Dehradun) Uttarakhand
Phones.: 0135-2430942, 2439551; 2439552, 2439553, 2439554, Fax: (+135) 2430142
e-ntail : [email protected]
(A Unit of Nirma/ Ashram, Rlshlkesh)

Receipt Printed On:

.·., .1• • ---._ Tuesday, April 11 , 202:
---
• I
.1 R_eceipt No :NAH/Receipt/23-24/3515
. \ I

IPD No. NAH/IPD/2023/1811

Date : 11/4/2023
UHID: Label4
Patient Name :Ms. PARWATI
Age I Sex : 30/ F
· Ii .
. i
- --- --

..I Cash Against Invoice No. :NAH/INVOICE/23 _

241209
I
11
Invoice Date : 11/4/2023
. ! !
' i' ·1 Invoice Amount :Rs. 27220
/I •

~ nature of Cashier

, , ~ j~ma
\ ' ..MBBS, MS (Orthopaedics)
\ . · MEDICAL DIRECTOR .;

............... - -..
UIIMI
I •.·.. -- - . • . _· ·.--.'
:.... .........

i
i •'
·.
1··1
,\

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,.
J·IJI.
;

,,, .We not only check the· pulse but touch your heart·.
f'J· ·••
ecurity Deposited :Rs. 2C
 .C \ ~ ~ 1 1
NIRMAL ASHRAM ...HO
Mayakund Rishikesh (Dehradun) Uttarakhand
Phones.: 0135-2430942, 2439551, 2439552, 2439553, 2439554, Fax: (+135}2430142
e-mail : [email protected]
(A Unit of Nirmal Ashram, Rlshlkesh) Pri nted Or,
. Receipt Thursday Apr, / 06 . 202J

N.L\l 1. f{(; ( '.- !I'

UHIO NA H/2023! 196970
Ref
Da le 6/4/2023
Age / Sex 30.' r- [

:: ;1 /\Jo Particui cJ 1
Rate Unit servarn ;:
118 , lL C DI C -
•
180 180
nsH (Giu co~(' l,;1111 1,)fll)

-- 50 1 50

:J . it: · r1 C, ~:;: tu11. ~.

-- 100
100
70
100
1no
70
- 200 2011
u
. (
250 ?50
• , I I_ t \ i[ !) '
250 ?.5c·
oO 60
60 60
200 4
; Sh C i/,. i 1. yrc1 · .,:,1: !li:l t1r!g Hormone) / 200
Total : Rs . 1520

We not only check the pulse but touch your heart.

1
 -~~l{Rrfe'II
NIRMAL ASHRAM HOSPITALEstb.1990
Mayakund Rishikesh (Dehradun) Uttarakhand lndi
Phones.: 0135-2430942, 2439551, 2439552, 2439553, 2439554, Fax: (+135) 2430142
e-mail -: [email protected] !430
(A Unit of Nlrmal Ashram, Rlshlkesh) 1l1.c
Date : 7/4/2023
Receipt P ri
IPD: NAH/IPD/2023/181
: NAH/Receipt/23~24/232_
0
:eceipt No. / F
: NAH/2023/196970
UHID Age & Sex 30
Name
Ms. Ms. PARWATI Amount--
Particular - ---- 200() - OD :
Sr.No
security Deposited
1

· Signa] jf cashier it

- -- ,Dr; Aja
. I \ ··: Sharma ·
i -.:MBBS, MS (Ortbopaedic1)
..
I

1,.-.--~. ........_- >

\ . . · MEDICAL 0IRECTO~-~
.. ,,. .QIMC .....No.
_ :- ..... . . ..-.... .....- . ,a

•' 1

We -not only check the pulse but touch your heart.

: :Rs
~ P.rtnsltecl :Rs.
 N I ~ ASHRAM HOSPITAL lllb.1990
· Mayakund R11hikesh - 249201, Ofstt. Dehradun, Uttarakhand, India
Ph.: ~135-2430942, 2439551, 2439552, 2439553, 2439554, Fax: 24301'2
Website·- www.ninnal~ospitals.com : e-mail : [email protected]
(A Unit of Nirmal Ashram, Ris~ikesh)
i Print Dt. 1:41:16 PM
~ sday, April 11, 2023

- - - - --- _, ____
UHID NAH/2023/196970 Date :11/4/2023
Bill No : Cash/ NAH/INVOICE/23-24/209
DOD : 11/ 4 I 2023
DOA : 7/ 4 I 2023
IPD NAH/IPD/2023/1811
- - - --- -- - - - -
W/o ROSHAN SAHU
30 IF ;
Patient Name : Ms. PARWATI
T-07,MANERI DAM COLONY
PtAddress:
UTTARKASHI
----------
- - - - - - -- - - --
Security Receipt No. : , NAH/Receipt/2_3-24/2320
Security Deposited :2000

Ward : Female General

Bed No: 53 --------
Doctor Dr.Ajay Sharma
Unit Amount (Rs.)
Rate ---------1
Service
Sr. No. -- --· ---- ------ - 200
200
Medical Record Fee
400
400
Recovery Ward / Post Operative Ward IPC(Dr.A;ay Sharma)
2 4 800
200
General Ward IPC (Dr.Ajay Sharma)
3 670
670
Recovery Ward / Post Operative Ward
4 750
250 3
General Ward Charges
5
15000 · 15000
Ortho Surgery· Charges
6
5250 5250
Anaesthesia Charges(Dr.Mohneesh Kumar Saiyam)
7
300 300 .
Pre Anaesthetic Chec-kup
8
3500 3500
9 OT Charges

~r
•'.' / ..
;/
10 Minor Dressing in OT
100 100

250
250
,I 11 Forearm AP/LAT X-Ray
0
0
r
·1
D

I
Bill Amount :Rs. 27220
Less Security Deposited :Rs. 2000

I
Balance-Rs. 25220

~ ure of BUling Clerk

 c;ENESIS SURGICAL SOLUTIONS
KHASRA NO.1980,WARD NO.-7, ADARSH NAGAR, JOLLY GRANT,
DEHRADUN
State: UTTARAKHAND Code: 05
Phone No. : 9927213475,9411313280
D.L.NO.: 20:117452, 21:117453, 20B:11754, 21B:117455,
GST No. : 05AKWPP2537M1ZG Pan No. :AKWPP2537M
Emall : genes\[email protected]

M/s. CASH LEDGER Inv. No.: GSS-23-24/00072 Date : 10/04/2023

D.C.No. D.C.Date
P.O. No. P.O. Date

STATE: Uttarakhand CODE Tpt.

J
DL NO.: P.Name: PARWATI DEVI (0SAAJCS7141Q1ZS)

GST : Pan No. : Surgeon: C/0 :NIRMAL ASHRAM HOSPITAL

PHONE : / Eway Bill No.:

Sno Item Description Part No. Brand HSN Qty. M.R.P. Rate Dis% GS Amount

2 MP071AT-07 MEDPLUS 90211000 2 6500.00 3600.00 0.00 5% 7200.00

1 SMALL LOCKING PLATE 3.SMM
START X 7H TIT

MP072AT-14 MEDPLUS 90211000 4 1800.00 900.00 0.00 5% 3600.00

2 CORTEX LOCKING HEAD SCREW (
S.T) 2 START 03.SMM X 14

MP072AT-16 MEDPLUS 90211000 2 1800.00 900 . 00 0.00 5% 1800.00

3 CORTEX LOCKING HEAD SCREW (
S.T) 2 START 03.SMM X 16

4 CORTEXSCREW03.5MM l.25MM PX
16MM(S.T.) TIT
MP003T-16 MEDPLUS 90211000 1 1000.00 500.00 0.00 5%
soo.,i
5 CORTEXSCREW03.5MM 1 . 25MM PX MP003T-18 MEDPLUS 90211000 4 1000 . 00 500.00 0.00 5% 2000.00
18MM(S. T.) TIT
-
- ,

'/' ' '

20MM ''''''·'"' '·''"''' /"'''''·,.-
MEDl'LUS
- - ---
90211000 11 1000.00 500.00 e.::a/ 5%1
I "'·"\ 11

I
I
I

\
\
Bank Details: AXIS BANK LTD A/C No.922030039192600 SUB TOTAL 15600.00
/ IFSC Code:UTIB0003427 Branch: DOIWALA, DEHRADUN ( U.K) Less Discount 0.00
Value ZERO% 5% 12% 18% 28% Less Special Discount 0.00
Base Value 0.00 15600.00 0.00 0.00 0.00 ADD SGST 390.00
Discount 0.00 0.00 0.00 0.00 0.00 ADD CGST 390.00
Taxable 0.00 15660.60 0.00 0 . 00 1:1.00 I ADD/LESS 0.00 )
SGST + CGST 780.00 0.00 0.00 0 . 00 ADD/LESS R0UND OFF 0.00 /
TOTAL 0.00 16380.00 0.00 0.00 0.00 GRAND TOTAL 163so.oo I
Rupees Sixteen Thousand Three Hundred Eighty Only

Terms & Conditions :-

c-.ood, once wld wm not bit Ul\i.en b ack o r b.chan1e. Kindly ma\,,e P.ivment within 30 d.ivs other,,t,1i se interut 11!)30" p .a . v. ill be 11:h•raed.
Pr'i~ \~ I C.Omp••W will be re,pon,ib\e for •U lM Wi11rr1nt1e1. of the Producu \nca s.e of cheque bounclni , n,;;;omer will be 1i.abl• 10 P•V fh . 5,00/ ••• 1••
"'1 d"oute, 1,ubj~, to OEHI\AOON lur\1.dlction only. E.& a , E. Autho

'This Is Com uter . enerated Invoice sl t t req!,!.lred coro culsoQ!'.~ -

G .. qna ure no =--- . +g:1.-s,q - saa-35757 / s,327-40-3047 or visit www.
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