"",, f't~

P L R T I N I Jf'v-1
H OSP t TRLB
MUI UNll
PEH-2020 -1362 C o 11 c o r11 C I A 'ls
Co 111pn ~s lo 11

Ja 0
FINAL BILL CUM RECEIPT
Ref. N
Hospital Reg N o . : P~ 7 ◄ 0 l 7 9 l
1949 I 2024 - 2025
IPD No. 2 136 I 2 0 24 - 2 0 25 BIii No.
BIii Date 16/ 01/202 5
UHID No. 2 0 2 4 - 2 0 25 I 2584 83
Admissio n Date & Tim'3 13/01/20 25 11 : 01 AM
Patient Name Mrs. Reeta Pandey
Twln_Sharing Discharg e Date & Time 16/01/20 25 04 :45 PM
Class
Referred By Dr.Bijoy Kutty
Doctor In-Charg e Dr. BIJoy Kutty
49Y SM 12D /Female Discharg e Status Relieved
A,ge / Gender
Final Diagnosis Suraical site infection

Qty Rate Amount

SNo. Service Name

BED CHARGES
1 4000 .00 4000.00
BED NO . 14 Twin_Sharing For The Date
13/ 01/ 2025 4000.00
Sub Total .......

CARDIOLOGY
1 3000.00 3000.00
2 2-D Echo
1 550.00 550.00
3 ECG
Sub Total ....... 3550.00

VISIT CHARGES
1 3000.00 3000.00
4 CVTS Surgeon Visit by Dr. Bijoy Kutty
Sub Total ....... :!tr.;C.00

GENERAL SURGE~Y
1 10000.00 10000.00
5 Debrideme nt
Sub Total ....... 10000.00
Total Amount : 20550.00

Bill Amount 20550.0 0

Less Discount ( 51 %) 10550.0 0
Net Total 10000.0 0
Less Deposit 10000.0 0
Less Receipt 0.00
Less Receipt( Disc + TDS + IPF 0.00
Other Discount )

Balance Amount 0.00

Paid Amount ( In Words ) Ten Thousand Only.

Balance Amount { In Words ) Zero Only.

Cashier J
Deposit Details
SNo. Mode Rec. No Rec. Date Inst. No Inst. Date Amount Deposit Type
1 Debit 3368 13/01/20 25 2062 13/01/20 25 10000.00 Against Bill
Card
at 16:56 16
This bill was printed by yog esh using Caresoft HIS www.caresoft .co.ln on 16-01 -2025 Page 1 of 2

Checknaka, Mulund (W), Mumbai. 400 080.

Platinum Hospitals : Color Scape Shopping Mall, G-103, D. D. Upadhyay Marg, Mulund
/ 2560 0190 / 2560 0191 I Emall: lnfoOplatl numhospitalmulund.in
For Appointment : Tel : 022 - 6171 0700
umhospita lmulund.in I Any Time Call : +91 70 58 600 600 / +91 70 58 800 800
Website : www.platin
 ; VIS ION HEA LTH CAR E
I

Upa dhy a y
C olor $ c~ p e S hop pin g M a ll, G- 10 3 , D . D.
Mum bai - 400 080
M a rg , Mu.Jun d C h eckn a k a , Mul und (W)
I

BI LL C U M R 6C EIP T

Receipt/Reg No r 2136 Date 16-J an-2 5

11 :20 AM
Name Mrs
I
I
. REETA PANDEY 1

Age 49 Year Female

Ref By Dr. : br. BIJOY KUTTY
~
Amount (Fee)
# Procedure I Test' Name
'
2000
1 RENAL FUNCTIONI' TEST FULL
I• Total Fee: 2,00 0.00
. I I

! (+'i Visiting Charges: 0

':
!
i I
(t) Other Charges: 0
.:
I
I
Total: 200 0.00
- ----- - - -
Discount: 500
PaymentType: G.PAY Ir-r ,· ]
\ Paid Amount: 1500
I , }

•
'
I j Balance Amount: O
i

Cre dit Amo unt: 0

For. VI_SION HEALTH CARE

f i' : ,·

i· [
,,

User: · Adnilirt
~5 7:56:45 AM.
Log:in Session:· 1~-J.a' ri;.. I
.

~I~ ~eports to be collecte/d After 7.00 pm.

 PLATINUM HEALTHCARE
L & COLOUR
WEST40ooao
SHOP NO -1 ,G-103, PLATINUM HOSPITAL MALL DHAMA SCOPE MALL D.D.UpADHAYA MARG , MULUND
Tax Invoice
GSTIN • 27AAXFP5020A1ZC
7884
J'\. Nos. MI-I-MZ 4-31216 1/MI-I-M ZA-312 162 ND2-42
24648 Cash Memo• 211277
Patient: RE.ETA PANDEY
Doctor: PLATI NUM HOSPITAL

Date 16/01/25 17 03
QNTY
PRODU CT DESCR ITPION
1 HSN MFG.
x 100ML BATCH-No ExpDt Cess¾
NS (AQUA) GST%
1 X500M L

\
RL(AQ UA) DENI 1475
1 10/26 -47.10
x 100ML 3004 AQUA 7229
THERM OCHILL G IV 11/26 -72.70
2 x 1 VAIL
MENTIPAN 40MG INJ 22 08/26 12.00 -642.00
2 x 1 PIC
NIPRO SYRING 1OML 09/26 12.00 -113.00
2 X2ml 9018 NIPR
I ONDET INJ
3004 INTA
08/26
-50.00
-26.70

DIKE
Amoun t -951 .50
Consu lt Doctor before using Medici ne
~
RP.Sign
Less
Net Amoun t -952.00
0 E Subjec t to M u mbai Jurisdic tion
i::~849.55,6%SG S T -50.96 ,6 % CGST -50.96
 s MH
~
_,,,,,,,r SH OP
-M Z4 -31 21 61 /M N0 .1, G- 10 3,P LA TIN UM
H- MZ A-3 12 16 2
RE ET A PA ND EY
ND 2-4 27 88 4
HO SP ITA L MA
PL A TI N U M HEAL
LL DH AM AL & CO
LO UR SC
THCARE
OP E MALLO D
----
· .UPADHAYA MA
RG ,
MU LU ND W EST4
000SO
GSTIN 27A MF
Ta:,: \nvc.,c.e

P5020A
,
i ZC
PL AT IN UM HO Cash Me mo : 211278
SP IT AL

Date 16/01/25 17·08

QN TY

HSN MFG. BATCH-No

'\ ExpDt GST¾ MRP/RATE AMOUNT ee ss ¾
'\ OMEG 23280
CL OP \TA B 75 MG
1 11/25 12 .00 40 .00 40 .00
X 10 T LQ U\ N 500 3004 LUPI 1971 01/26 12.00 111 .80 111 .80
1 x2 0T ME T XL 25 MG TA 3004 CIPL 24033
B 02/27 12.00 100.6 9 10 0.69
1 X 10 T GLYCOMET 50 3004 AJAN 19564
0MG 09/27 12 .00 95.20 95.20
3004 U.S . 0360 10/27 12.00 20.40 20 .40

DIK E Am ou nt 368.09
Co ns ult Do cto r Less
be for e us ing Me
dic ine I Ne t Am ou nt
~ ign
368.00
E&
0 E. Subject to Mumb
ai Jurisd iction
Tld>l.328.64, 6%
SG ST 19. 71, 6%
CG ST 19.71
 VISION HEALTH CARE

Co lor $cape Shopp ing Mall, G1- 103, D.D. Upadh yay
Marg , Mulund Checkna ka, Mulun'd (W) Mumb ai - 40008 0
I

BILL CUM RBCEIPT I

ReceipUReg No 2136 Date 13-Jan-25

' 6:11 PM
Name ~: Mrs. REETA PANDEY
l Year Female
Ref By Dr. ~ Dr. BIJOY t(UTTY Age 49
Amount (Fee)
# Proced ure I Test' Name
COMPLETE BLOOb COUNT
330
1
2 PUS CULTURE
1560

RENAL FUNCTION TEST FULL

2600
3 I

Total Fee: 4 ~490.0 0

!
(+)Vis iting Charges·: 0
I

( +) Other Char.ges.: 0
' '
4490. 00
- -- --
Discount: 0
Payment Type: G.PAY !.t
Paid Amount: 4490
I

! Balance Amount: 0

Credit Amount: 0

For. VISION HEALr~· CARE

,,

l
User: Adrnin
Login Session: 15-J;an-25 5:34:46 AM
All report s to be collec tep After 7.00 pm. . -
 - - - - ,-. NE ALTH C AR E - · -
- - - - - - -- .
Co lor Sca pe Sh opp ing Ma ll, G -
103 , D.D . Up adh yay
Ma rg , Mu lun d Ch eck n il ka, Mu
lun d (W ) Mu mb ai - 400 080

BIL L CU M REC EIPT

Re cei pt/R eg No t 213 6 I

Na me · Mrs. REETA PANDEY ! Date .i 15-Jan-25

Re f By Dr.
i: Dr. BIJ OY KUTTY I 6:13 PM
# Pro ced ure / Te stI Na me
I

Age 49 Year Female

1 PUS CULTURE Am oun t (Fee)

1560
.I Tot al Fee :
1,5 60. 00
( +)I Vis itin g Cha rge s:
0
.(+) Other Charges: 0
·-- -
I
__! ___ Tot al: 156 0.0 0
Pa ym ent Typ e: G.PAY ·:;
Dis cou nt:
0
H Pai d Am oun t: 156 0
Bal anc e Am oun t:
i 0
i Cre dit Am oun t:
0
1
Fo r. VIS ION HEALTH .-CA RE
- . :

User: Adm in·

M
. ~ -
L~ n Se ssi on: 15 -~~ - 25 5·3 4:4 6 A
·
1

·
-~ ~II rep ort s to be co llec teld Aft er 7.00 pm.
. ; .
 Tax Invoice
PLATINUM HEALTHCARE
S\-\OP NO .'\ ,G-, O~.?lA,\N\JM \-\OSP\1AL MALL 0\-\AMAL & COLOURSCOPE MALL D.D .UPADHAYA MARG, MULUND WEST400080
rl-MZ4-3i2i6"~~-MZA-3i2i62 ND2-427884 GSTIN : 27MXFP5020A1ZC
REEiA PANOE't' Cash Memo: 211079

PlAi\NUM HOSP\1Al 14/01/25 18:11

Date

PROOUCi OESCR\iP\ON HSN MFG. BATCH-No ExpDt GST¾ MRP/RATE AMOUNT Cess%

x "\ PC ECG LEA.OS 90'\8 08/26 12.00 36.00 216.00

x 500ML Rl lAO.UA) 11/26 12.00 72.70 145.40
x 500ML NS lAO.\JA) 11/26 12.00 98.40 295.20
N\PRO S'<R\NG 10Ml 12.00 25.00 50.00
BO NEEDLE 11/28 12.00 4.50 9.00
PN\O l\NE 200 lMF) 03/27 12.00 350.00 350.00

Amount 1065.60
DIKE Less
Consult Doctor before using Medicine Net Amount 1066.00

E.&.O.E. Subject to Mumbai Jurisdiction

Txbl 951 .42,6% SGST 57 .08 ,6% CGST 57 .08

J
 .-~ ~ ~ tl -~ ~ -- -- 'r'" -
· ~,,,, nv: :,1- 'ITA L MA . " .. u IVl HEAL. I n vr'\ 1 H-
.., ",t-1 "-1L..,"'--312162 ND 2-42 LL DH AM AL &
I ,g& ;:~E.-u:
PA ND EY - - - -~ ..: :.:
7BS4
:._ :_ _~ -- -- CO LOU RS
-- -- -- --- ·-_ _
coP E MA LL D.D .UP
AD HA YA MA RG . MU
LUND WEST
4
• ~~-
00080
GSTl N r,¼X;:os.,"2:-
1 z~
PL AT INU M HO SP Cas h Memo 2
ITA L
11102

Date
QN TY 14/ 01/ 25
PR OD UC T DE SC RIT
PIO N
HSN MFG . BATCH-No Exp ot GST%
x 100 ML I MR P/RATE
NS (AQ UA ) AMOUNT
x2 ml DENI 146 7 10/ 26
Ces s%
ON DE T INJ 12.00
x 225 ML 47.10
CR EM AF FIN SYP PL 3004 INTA 081 3 07/ 26 <17 10
12. 00
US 13.35
13.35
300 4 ABBO 692 562 08/ 27 12. 00 327 .58
327 58

I
)

J
I
I
I

J_ Am ou nt 388 .03
rJJ~.E.".-H ,
(,rJ r,::, u/1 uo cw r bef ore usi ng
Me dic ine Les s
Ne t Am ou nt 388 .00
r ~ '✓ JU)! ::'-' 1,.., M urri1.,a1
r.,;;, (.J
1
'.; 4 6 4!.. 6"11. t,,rj~
( ~fJ
Jur1sd1 c 11on
l'.J ,1-,~A., r;.6t ; f LO
7fJ
 I
/ f - - - - - - -P
- LA-r,-Nu_MHE_AL-TH-CA_R_E- - - -- -
sHoP NO.1,G-103,PlATINUM HOSPITAL MALL DHAMAL &COLOURSCOPE MALL D.D.UPADHAYA MARG, MULUND WEST400080
24-312161/MH-MZA-312162 ND2-427884 GSTIN 27AAfFPfJJ2G1-· z~
I
Cash Memo: 211207
I • I

octor. PLATINUM HOSPITAL Date 15/01/25 ' ',Ji

M.R.P. QNTY PRODUCT DESCRITPION HSN MFG. BATCH-No ExpDt GST¾ MRP/RATE AMOUNT Cess%
x1OOML REOLIV IV ACUL 1579 08/27 12.00 387.25 387.25

Amount J87.25
DIKE

~
Less
Consult Doctor before us· M ..
tng ed1c1ne Net Amount 387.00
R.P.Sign
E. & O.E. Subject t M
Txbl 345. 76,6% SGST °
20·75,6%umba1
. . .
Jurisdiction
CGST 20.75
 Tax Invoice
PLATINlJIVI HEALTHCA RE
L& PE MALL D.D.U PAD HAYA MARG, MULUN D WEST400080
SHOP NO .1 ,G-103,PLATINUM HOSPITAL MALL DHAMA GSTI N : 27 AAXFPS020A1zc
COLO URSCO
-312161 IMH-MZA-312162 ND2-427884
--------- - ~
Cash Memo: 211219
REETA PANDEY

PLATINUM HOSPITAL
Date 15/01/25 20-.56

QNTY
PRODU CT DESCR ITPION
HSN MFG. BATCH-No ExpDt GST% MRP/RATE AMOUN T 1Cess%
X20G BDVEN FLON
BEAC 10593 07/29 12.00 193.00
x1PC POLYMED 22G 193.00
X1 POLY 24H 07/29 12.00 193.00
ROMSON 3WAY SMALL 193.00
ROMS 11046 09/29 12.00 163.00 163.00

OURESH/
Amoun t 549.0Q
Consult Doctor before using Medicine Less
Net Amoun t 549.00
E.&.0.E. Subject to Mumbai Jurisdict ion
Txb/ 490.18,6% SGST 29.41 ,6% CGST 29.41
 . --~ -.. pa1 1ue ~ -
24 64 8 - .
GST IN L7AAXFP5020P
·zc
Do cto r: Cash Memo : 2109 2
PL AT INU M HO SP ITA
L
4 2

Date 13/01/25 ' 3~:

M.R.P. QN TY
PRODUCT DESCRIT
PION
HSN MFG. BATCH-No Ex pD t GST% MRP/RATE
1 x2 0G AMOUNT
BD VE NF LO N ~ %
1 x1 RO MS ON 3WAY SM BEAC 105 93 07/ 29 12.00 193 .00
ALL '19.3 .G0
1 x1P AC POLY I.V.SET(NOVA) RO MS 11046 09/ 29 12. 00 163 .00 163.00
3 x 1V IAL 9018 POLY 882 4L 09/ 29 12.00 258 .00 258.00
TA ZO CIL 4.SGM INJ
2 x 1V IAL 3004 OS CA 907B 08/ 26 12.00 447 .00 134 1.GO
PA NV ISA 40M G
3 x2 ml OS CA 41 1 07/ 26 12.00 56 .50 11 3.00
ON DE T INJ
2 x 10 0M L 3004 INTA 0813 07/26 12.00 13.35 40.05
TH ER MO CH ILL G IV
3 x 100 ML
AKUM 632 2T 08/ 26 12.00 642.00 1284.00
NS (AQUA)
DENI 1467 10/ 26 12.00 47.10 141.30
2 x 1 PIC NIP RO SYRING 10M
L 9018 NIPR 12456 12.00 25.00 50.00

\
I -

PRASHANT
I I
Amount
I
3583.35
Co nsu lt Do cto r bef ore

:. &.O.E.
using Medicine

Subject to Mumbai Juri

·x bl 3 199.42,6% SGS T
..
sd1ct1on
191.97,6% CGS T 191
.97
f! Le ss
Ne t Am ou nt 3583.00
 - --- ra-,, ~,n,u,
SHop No PLATINUM HEALTHCARE
31-103, PLATINUM HOSPITAL MALL DHAM RSCOPE MALL D.D.UPADHAYA MARG , MU LUND WEST400080
~;~~~l
~ M 1.G
AL & COLOU GSTIN 27AAXFP5020~ ·zc
REETA Pi_' I\IDEY
H-MZA- 2162 ND2-427884
24648
Cash Memo: 210984
-

~ \..
Doctor
PLATINUM HOSPITAL
._ Date 13/01/25 20 31

0NTY
PRODUCT DESCRITPION
HSN MFG. BATCH-No Expot GST% MRP/RATE AMOUNT Cess%
1 x 1ML
INSULIN SYRING
2 X 1PAC 9018 B.D 136 03/29 12.00 11 .30 11 .30
GALLANT BLADE
1 X 100ML 9018 SURG 7565 01/27 12.00 95.00 190.00
PROCTO-CLYSIS ENEMA
2 X 27G .. 1.5 3004 SURG 2405 03/26 12.00 86.00 86.00
BD NEEDLE
SURG 105 03/29 12.00 4.50 9.00

I
I I

PRASHANT I\ Amount
Less
296 .30

~
Consult Doctor before using Medicine
Net Amount 296.00
E.&.O.E. SubJect to Mumbai Junsd1ct1on
Txbl 264.56,6% SGST 15.88,6% CGST 15 88
 PLATINUM HEALTHCARE
SHOP NO .1,G-103,PLATINUM HOSPITAL MALL DHAMAL & COLOURSCOPE MALL D.D.UPADHAYA MARG, MULUND WE ST400080
1
D.L.Nos. M~-MZ4-31216 /MH-MZA-312162 ~D2-427884 GSTIN 27MXFP50LO.A i ZC

Patient: REL ,~DEY Cash Memo: 211146

24648

Doctor. PLATINUM HOSPITAL Date 15/01/25 "C :3.3

\ aNTY DESCRITPION BATCH-No ExpDt GST%

I 1 PRODUCT HSN MFG. MRP/RATE AMOUNT Cess%

I 3
2
1
x 1VIAL
x 1 VAIL
x2ml
TAZOCIL 4.SGM INJ
MENTIPAN 40MG INJ
ONDET INJ
3004

3004
OSCA 9078
H.B.
INTA
27A
0813
08/26
09/26
07/26
12.00
12.00
12.00
447.00
56.50
13.35
1341 .00
113.00
13.35
3 x 100ML NS (AQUA) DENI 1467 10/26 12.00 47 .10 141 .30
1 x 1ML INSULIN SYRING 9018 B.D 136 03/29 12.00 11 .30 11.30

I
Amount 1619.95
RINKY
Less
Consult Doctor before using Medicine
Net Amount 1620.00
RP.Sign
E.&.O.E. SubJect to Mumbai Jurisd1ct1on
Txbl 1446.39,6% SGST 86.79,6% CGST 86.79
 SHOP NO 1 G-103,PLATINUM HOSPITAL M
D.L.Nos . MH-MZ4--312161/MH-MZ:.X-~12162 ND2-427884
· ·
-
PLATINUM HEALTHCARE
- 4
00080
ALL DHAMAL & COLOURSCOPE MALL D.D.UPADHAYA MARG MULUND WEST N 27 AAXFP5020A1ZC
~------- ' GSTI :.
Tax Invoice

Patient: ~ PANDEY - ---~-- cash Memo: 211017 2

24648

10:21
Doctor: PLATINUM HOSPITAL 14/01/25
Date

AMOUNT Cess%
QNTY PRODUCT DESCRITPION MFG. BATCH-No Expot GST¾ MRP/RATE
HSN
3 x 1VIAL 08/26 12.00 447.00 1341 .00
TAZOCIL 4.5GM INJ 3004 OSCA 907B
3
2
x 1VIAL
x 100ML
PANVISA 40MG
NS(AQUA)
OSCA 411
DENI 1467
07/26
10/26
12.00
12.00
56.50
47.10
169.50
94.20
I
2 x2ml 07/26 12.00 13.35 26.70
ONDET INJ 3004 INTA 0813

I
I
-~:..-.
r r
Amount 1631.40
RINKY
Less I
Consult Doctor before using Medicine Net Amount 1631.00
RP.Sign
I
E.&.O.E. SubJect to Mumbai Jurisdiction
Txbl 1456.62,6% SGST 87.40,6% CGST 87.40
 ,- ~

GSTIN · 27AAXFP5020A
Patien t: REETA PANDEY 1ZC
2 4 648 Cash Memo : 211023
Doc tor: PLATINUM HO SP ITA
L
Date 14/01/25 11 :15

QN TY
PRODUCT DESCRITP
ION BATCH-No GST% MR P/R ATE AM OU NT Ce ss%
HSN MFG . ExpDt
1 x20 G
BD VE NF LO N
1 x1 BEAC 10593 07/29 12.00 193 .00 193 .00
ROMSON 3WAY SMALL
ROMS 11046 09/29 12.00 163 .00 163 .00

_j
RINKY
Consult Doctor before usi
ng Medicine
r:j\J-J Amount 356.00
Less
Subject to Mumbai Jurisdic
R.P.Sign Net Amount
E.&.O.E.
Txbl 317.86,6% SGS T tion 356.00
19.07,6% CGS T 19.07
 SHOP NO 1 G 103 PLATINU
PLATINUM HEALTHCARE TaxlnVOice
~ - M~-MZ4 -312161/ MH-Mli\- ~1;162 .ND2-4
Patient: REETA PANDE Y .
2788 ~ HOSPITAL MALL DHAMAL & COLOURSCOPE MALL D.D.UPADHAYA MARG , MULUND
.
WE ST400080 I
GSTIN 27/>AXFP502CA'ZC
24648
Cash Memo : 211086
Doctor: PLATIN UM HOSPIT AL

Date 14/01/2 5 18 3 '

M.R.P. QNTY
PRODU CT DESCRI TPION
HSN MFG. BATCH- No Expot GST¾ MRP/RA TE AMOUNT
x 1 PCS Cess¾
PMO LINE 200 (MF)
9018 NEWT 0072C 03/27
xADULT VINJOH OXYMA SK 12.00 RETURN -350.00
9019 VINJ 007 06/27 12.00 450.00 450 .00

I
DIKE Amoun t 100.00
Consult Doctor before using Medicine
less
Net Amoun t 100.00
E. &.O.E. Subject to Mumbai Jurisdiction RP.Sign
Txbl 89-29,6% SGST 5.36,6% CGST 5.36
 BILL CUM R ECEJPT

Bill Date 13/ 01 / 2 0 2 5 Time 10:26 M 'I

Bi ll No. t O t .3 1
P a t i e nt N a n, e M r s. l { c-' r' l a Pa n d e y Ul-11D No. 2 58483
De p t . Ca rd1 0 T~ or~:: ~-
G e n d e r / L\ gc Fe m a le: / 4 9Y SM I 2 D
Surg e r 1

1) 1 . 131Ju y l<utly R e ferre d By D r . B1J OY r< u tt y

:-:, l"<o. Sc n,i .-::c Q ~y A m oun t

[ CG 400 .00 1 4 00.t)O
GENERAL EC HO 2,500 . 00 1 2,500.00

l 1\·1> rhou~a n d Nin t: Hu n dre d O nl y Net Amount 2,900.00

Am o unt R e ceivable 2 , 9 00.G C

I 1\ 1 0 i-t1o u sa ncJ [\Jin c H u nd 1-c d On ly Amoun t Paid 2,9 00.00

·,,ro On ly Balance
Pa yme n t D e t a ils :

I I
,:,:~:--1
P a y. / Am o unt Ins. No. irns . Da~ Ba nk
;- .s;.o. : :c. Re c. Date

2, eoo ~-(-) --+-,-5_-3_7_9_6_9_(_J_~- ": > _S -1:---\-- - - - - ''---4- -- --

___
-+-1-J_/_c.1_1_; _2.__u
\--:·--~~~ I 3/ 0 I /2 1l 2'
6359 i
I

3Sd f 1 0 l 31 10 2 6 Password: asd f10131 1 026

Ru c hi l a Su t ar Pri nted On D.:s t e & T ; m ~: .1 3/0.1/ 2025 L 0 :2 6A M
h11 -~1 •1u · r;1t c: d hv:
 ~
~ PLATIN~~J~~~~~Ie~t~~~~?FI~~~~~~~F(£NT£R
DD Upodyo Marg, Mulund West, Mumbai -
o, : 400080 . '
Mob .: 75075 l 7874 / 9987379355
f)atien
· ,ts Name :_ _ _ ~ 13 0
_J /:j ~~L- -~ ~. :,. J.. }.~ Date .
Hosp·1ta1
Name : _ _ _ _.llJ ~d: 1:. tJ.3 'S..
--- :-- =- - 1r J 2-J
CL --4 L2 -J.J .:.i ..;. ~"- --:=
Ba g No. Qty .

1. o..
(ln: ~Pl119 & Cro ss- Ma tch ing
Udl ng of Coo mb 's Test)
2. s.
(In ""I ce Ch arg es
An~:Uding of HB sAg . Ant i HIV
Hcv, VDRL, M.P. Charges)(1+11),
3. E111
el'g enc y

4 • Ot he
r

S. B. T. Se t

1 Ha ve read the ins tru ctio Total

ns
given over lea f
~ ' l l t i t ~ ~ ~ ~- Less Dis cou nt

Net Am oun t
-
For PLATIMUM HOSPITAL
·········· ~·········································································
To, Blo od Tra
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ns fusi on off ce r,
PLATIMUM HOSPITAL BLOOD STORAG
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