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receipt_1726222005

The document is an outpatient bill from Fortis Hospital in Kolkata for Mr. Palan Molla, dated September 13, 2024. The total bill amount is 350.00 INR for a consultation with Dr. Priyam Mukherjee in cardiology, with no discounts applied and the full amount paid by the patient. Contact details for the hospital and payor, Food Corporation of India, are also provided.

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rumpamondal040
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45 views2 pages

receipt_1726222005

The document is an outpatient bill from Fortis Hospital in Kolkata for Mr. Palan Molla, dated September 13, 2024. The total bill amount is 350.00 INR for a consultation with Dr. Priyam Mukherjee in cardiology, with no discounts applied and the full amount paid by the patient. Contact details for the hospital and payor, Food Corporation of India, are also provided.

Uploaded by

rumpamondal040
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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Fortis Hospital, Anandpur, Kolkata

730,ANANDAPUR,EM BYPASS
ROAD,KOLKATA-700107 UPI SCAN
Tel: +91 NA, 03366284444 | Fax: 033- & Pay
66284242
Emergency: 105711 | Ambulance: 105711 GST
Email:enquiries@fortishealthcare.com | No:19AABCF3718N1ZB
Website: www.fortishealthcare.com

OUT PATIENT BILL


Primary
: Dr. Priyam Mukherjee
Name : Mr. Palan Molla Doctor
UHID : 13348353 Ref Doctor : Direct Walk in
Contact No. : 8910414200 : FOOD CORPORATION OF INDIA
Payor Name
Age/Sex : 63 YEAR(S)/Male LIMITED
Episode No. : 150240/24/1116 Payor Site
: CALF00175A-REGIONAL
Name
Bill Date : 2024-09-13 15:34:00
Print Date : 2024-09-13 15:34:00 Discount
: NA
Scheme
: VILLAGE+P.O- MADARAT
Patient BOTTALA P.S- BARUIPUR Insurance : NA
Address Kolkata. 743610 West Bengal TPA : NA
India CIN No : U93000DL2009PLC222166
Emp.Name : NA

BILL NUMBER BILL TYPE BILL DATE BILL AMOUNT


111624OPCS167930 CASH 2024-09-13 15:34:00 350.00

Accession HSN Service Contractual Net Gross


Sr No. Particulars Qty
No Code Amount Discount Amount
CONSULTATION-Priyam
1 999312 1 350.00 0.00 350.00
Mukherjee (CARDIOLOGY)
TOTAL AMOUNT 350.00 0.00 350.00
BILL AMOUNT 350.00
PAYOR SHARE 0.00
PATIENT SHARE 350.00
TOTAL
0.00
DISCR.DISCOUNT
PAID BY PATIENT 350.00
NET PATIENT
350.00
PAYABLE
BILL ROUND OF
0.00
AMOUNT
Rupees in Words: Rupees Three Hundred Fifty only
Payour details
FOOD CORPORATION OF INDIA
Name:
LIMITED
Address: CALF00175A-REGIONAL
GSTIN: CALF00175A
Prepared by Sulagna Gupta Cashier Manager
Note: None

Reciept Details
Sr No. Reciept No. Reciept Date. Amount Balance Amount Payment
1 1116/DP/2409/190223 2024-09-13 15:34:00 350.00 0.00 350.00

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 computerized generated invoice doesn't required signature.


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