September 30, 2024

Invoice Details
CENTRAL HOSPITAL LIMITED

BHTNo: CHL0159477

BHT No. : CHL0159477 Arrival : 30/Sep/2024 5:54:00AM

Patient Name : MR S.T. GATHILIMUDALI Depature :
BedRoom : 1124
Bill No : FBL0399499

Description Room No Amount

ROOM CHARGES
ITM0000068 ROOM CHARGES 1124 Days 0.50 @ 27,499.92 = 13,749.96 13749.96
13,749.96

CSSD
SER0000178 CSSD 1124 Days 1.00 @ 1,500.00 = 1,500.00 1500.00
1,500.00

GENERAL NURSING CARE

SER0000102 GENERAL NURSING CARE 1124 Days 0.50 @ 10,000.00 = 5,000.00 5000.00
5,000.00

LAUNDRY/LINEN
SER0000104 LAUNDRY/LINEN 1124 Days 1.00 @ 1,000.00 = 1,000.00 1000.00
1,000.00

RESIDENT MEDICAL OFFICER CHARGES

SER0000103 RESIDENT MEDICAL OFFICER CHARGES
1124 Days 0.50 @ 10,500.00 = 5,250.00 5250.00
5,250.00

CostCenter CreateDate BillDate QTY UnitPrice Amount

LAB LABORATORY
LAB LABORATORY
ecg ECG 02403330/09/24 30-Sep-2024 30-Sep-2024 1.00 1,850.00 1,850.00
bioplc HISTOPATHOLOGY REPORT 02404430/09/24 30-Sep-2024 30-Sep-2024 1.00 26,420.00 26,420.00
28,270.00

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 CostCenter CreateDate BillDate QTY UnitPrice Amount

OPTH OPERATION THEATRE - GENERAL

THCHR THEATER CHARGES
ITM0000070 THEATRE CHARGES THE0079787 30-Sep-2024 30-Sep-2024 1.00 4,180.00 4,180.00
4,180.00

THCON ANESTHESIA MEDICATION & CONSUMABLES

ITM0000341 MONOPOLAR DIAPHOMY THE0079787 30-Sep-2024 30-Sep-2024 1.00 615.00 615.00
ITM0001049 ISOFLORAIN 1 ML THE0079787 30-Sep-2024 30-Sep-2024 4.00 440.00 1,760.00
ITM0000071 THEATRE CONSUMABLES THE0079787 30-Sep-2024 30-Sep-2024 1.00 1,000.00 1,000.00
ITM0000145 LARYNGEAL MASK (LMA USED) THE0079787 30-Sep-2024 30-Sep-2024 1.00 860.00 860.00
ITM0000328 POM+VEN+MONITER PER MINITE THE0079787 30-Sep-2024 30-Sep-2024 20.00 48.40 968.00
ITM0000333 OXYGEN PER MINITE THE0079787 30-Sep-2024 30-Sep-2024 20.00 260.00 5,200.00
ITM0002514 N2O2 PER MINUTE THE0079787 30-Sep-2024 30-Sep-2024 20.00 88.00 1,760.00
ITM0000085 SODALINE USED UPTO TWO HOURS THE0079787 30-Sep-2024 30-Sep-2024 1.00 295.00 295.00
12,458.00

THEDR THEATER DRUGS AND CONSUMABLES

010003608 NEOSTIGMINE INJECTION IN2501329 30-Sep-2024 30-Sep-2024 5.00 611.20 3,056.00
010010783 IV SET INTRAFIX (G) WHITE IN2501329 30-Sep-2024 30-Sep-2024 1.00 1,075.00 1,075.00
010002849 BETADINE SURGICAL SCRUB 1ML IN2501329 30-Sep-2024 30-Sep-2024 20.00 124.85 2,497.00
010003490 MARCAINE PLAIN 0.5% INJECTION IN2501329 30-Sep-2024 30-Sep-2024 2.00 5,443.48 10,886.96
010006814 IV CANNULA 20G PINK (BD) IN2501329 30-Sep-2024 30-Sep-2024 1.00 1,405.95 1,405.95
010006825 VENTICARE BREA/SYS.(038-01-106A IN2501329 30-Sep-2024 30-Sep-2024 1.00 8,348.33 8,348.33
010007487 SURGICAL GLOVES SIZE 6 POWDERED IN2501329 30-Sep-2024 30-Sep-2024 1.00 684.00 684.00
010014373 VOLTAREN 100MG SUPPOSITORY IN2501329 30-Sep-2024 30-Sep-2024 1.00 1,378.46 1,378.46
010003565 FENTANYL INJECTION 2ML IN2501329 30-Sep-2024 30-Sep-2024 1.00 770.27 770.27
010007096 SURGICAL BLADE NO 11G (PARAGON) IN2501329 30-Sep-2024 30-Sep-2024 1.00 632.08 632.08
010007543 DISPOSIBLE CAPS [DISPOSIBLE] IN2501329 30-Sep-2024 30-Sep-2024 2.00 76.50 153.00
010005958 ALCOHOL PADS IN2501329 30-Sep-2024 30-Sep-2024 1.00 54.91 54.91
010018019 GAUZE SWABS 4*4 PLAIN 3S (END PRODUCT)
IN2501329 30-Sep-2024 30-Sep-2024 1.00 440.00 440.00
010007646 DISPOSABLE FACE MASK (LOOP) IN2501329 30-Sep-2024 30-Sep-2024 2.00 85.00 170.00
010006665 SYRINGE 3CC (NIPRO) IN2501329 30-Sep-2024 30-Sep-2024 2.00 231.00 462.00
010007213 SYRINGE 20CC L/L (TERUMO) IN2501329 30-Sep-2024 30-Sep-2024 1.00 532.00 532.00
010009431 YUNKER SUCTION SET 210CM (NEW) IN2501329 30-Sep-2024 30-Sep-2024 1.00 4,383.81 4,383.81
010006681 ECG ELECTRODES IN2501329 30-Sep-2024 30-Sep-2024 4.00 308.00 1,232.00
010018398 VOMIKIND INJECTION 2MG/ML [ONDANSETRON]
IN2501329 30-Sep-2024 30-Sep-2024 1.00 365.12 365.12
010003465 25% DEXTROSE 25ML IN2501329 30-Sep-2024 30-Sep-2024 1.00 438.02 438.02
010009271 SURGICAL GLOVES SIZE 7.5 (BLOSSOM) IN2501329 30-Sep-2024 30-Sep-2024 1.00 684.00 684.00
010007211 SYRINGE 5CC (TEREMO) IN2501329 30-Sep-2024 30-Sep-2024 2.00 385.00 770.00
010003956 WATER FOR INJECTION [PEUMI] IN2501329 30-Sep-2024 30-Sep-2024 1.00 122.50 122.50
010007478 EXAMINATION GLOVES - MEDIUM IN2501329 30-Sep-2024 30-Sep-2024 12.00 140.65 1,687.80
010004244 0.9% NACL IV INFUSION 500ML FSE IN2501329 30-Sep-2024 30-Sep-2024 2.00 880.98 1,761.96
010003945 ATROPHINE INJECTION 1MG/ML(MARTINDALE)
IN2501329 30-Sep-2024 30-Sep-2024 1.00 1,328.00 1,328.00
010011391 BETADINE SOLUTION 1ML IN2501329 30-Sep-2024 30-Sep-2024 60.00 80.19 4,811.40
010003597 FRESOFOL 1%-20ML IN2501329 30-Sep-2024 30-Sep-2024 1.00 2,283.06 2,283.06
010007072 SURGICAL BLADES 23G IN2501329 30-Sep-2024 30-Sep-2024 1.00 600.00 600.00
010006817 BACTERIAL /VIRAL FILTER -A IN2501329 30-Sep-2024 30-Sep-2024 1.00 3,656.25 3,656.25
010006912 AIRWAY 04 (RED) IN2501329 30-Sep-2024 30-Sep-2024 1.00 2,058.25 2,058.25
010007146 IV3000 (OPSITE)7*9CM IN2501329 30-Sep-2024 30-Sep-2024 1.00 1,111.70 1,111.70
010007212 SYRINGE 10CC (TERUMO) IN2501329 30-Sep-2024 30-Sep-2024 1.00 511.50 511.50
60,351.33

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 CostCenter CreateDate BillDate QTY UnitPrice Amount

PHAR PHARMACY
DRG PHARMACY DRUGS
010013699 T4 50MCG TABLET R0171543 30-Sep-2024 30-Sep-2024 3.00 12.10 -36.30
010013699 T4 50MCG TABLET IN2501373 30-Sep-2024 30-Sep-2024 3.00 12.10 36.30
010001010 PANADOL TABS 500MG IN2501373 30-Sep-2024 30-Sep-2024 12.00 3.49 41.88
010001010 PANADOL TABS 500MG IN2501650 30-Sep-2024 30-Sep-2024 30.00 3.49 104.70
010000565 ZYCEL 100MG IN2501650 30-Sep-2024 30-Sep-2024 5.00 123.80 619.00
010000565 ZYCEL 100MG IN2501373 30-Sep-2024 30-Sep-2024 6.00 123.80 742.80
010001783 ATORLIP 20MG TABLET R0171543 30-Sep-2024 30-Sep-2024 3.00 34.95 -104.85
010001783 ATORLIP 20MG TABLET IN2501373 30-Sep-2024 30-Sep-2024 3.00 34.95 104.85
010001278 PANTOCID 40MG TABLET R0171543 30-Sep-2024 30-Sep-2024 2.00 55.60 -111.20
010001278 PANTOCID 40MG TABLET IN2501373 30-Sep-2024 30-Sep-2024 3.00 55.60 166.80
010016612 SEGABIN SR 75MG IN2501650 30-Sep-2024 30-Sep-2024 4.00 29.33 117.32
010016612 SEGABIN SR 75MG IN2501373 30-Sep-2024 30-Sep-2024 6.00 29.33 175.98
010000959 METROGYL 400MG TABLET IN2501373 30-Sep-2024 30-Sep-2024 6.00 95.25 571.50
010000959 METROGYL 400MG TABLET IN2501650 30-Sep-2024 30-Sep-2024 5.00 95.25 476.25
2,905.03

SUR WARD CONSUMABLES

010020750 NITRILE EXAMINATION GLOVES POWDERIN2501650
FREE M (TOUCH) 30-Sep-2024 30-Sep-2024 6.00 140.00 840.00
010019771 SENICURE HAND SANITIZER 100ML IN2501368 30-Sep-2024 30-Sep-2024 1.00 541.02 541.02
010018023 GAUZE SWABS 3*3 PLAIN 5S(END PRODUCT)
IN2501650 30-Sep-2024 30-Sep-2024 8.00 392.00 3,136.00
010007543 DISPOSIBLE CAPS [DISPOSIBLE] IN2501368 30-Sep-2024 30-Sep-2024 1.00 67.50 67.50
010005958 ALCOHOL PADS IN2501368 30-Sep-2024 30-Sep-2024 3.00 48.45 145.35
010015413 SHOE COVERS IN2501368 30-Sep-2024 30-Sep-2024 2.00 112.00 224.00
4,953.87

WD11 WARD11
ADM ADMISSION & INPATIENT REGISTRATION CHARGES
ITM0000067 ADMISSION CHARGES ENT9003768 30-Sep-2024 30-Sep-2024 1.00 22,000.00 22,000.00
ITM0000067 ADMISSION CHARGES WPE1868155 30-Sep-2024 30-Sep-2024 1.00 11,000.00 -11,000.00
11,000.00

WP WARD PROCEDURES
WP0000111 RANDOM BLOOD SUGER WPE1868134 30-Sep-2024 30-Sep-2024 1.00 1,302.55 1,302.55
WP0000115 SHAVING DONE - OTHER THAN HEAD WPE1868134 30-Sep-2024 30-Sep-2024 1.00 3,247.45 3,247.45
4,550.00

Total : 155,168.19

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