JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Rupali |
| Age / Gender: | 33 Yrs / Female |
| Mobile: | 01330778843 |
| Address: | Madergonj |
| Invoice No: | LAB-2026-0197 |
| Billing Date: | 14-08-2026 11:44 AM |
| Patient Type: | Outdoor |
Ref. Doctor:
Dr. Muhammad Mohsin MBBS (DMC), BCS (Health), FCPS (Medicine), MD (Medicine)
Ref. Patient:
Hp
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | T3 | 1,000.00 |
| 2 | T4 | 1,000.00 |
| 3 | TSH | 1,000.00 |
| 4 | Collection Set | 25.00 |
| 5 | Edta Tube | 20.00 |
| Subtotal: | 3,045.00 BDT |
| Discount: | - 845.00 BDT |
| Grand Total: | 2,200.00 BDT |
| Money Received (Paid): | 0.00 BDT |
Patient / Guardian Signature
Authorized Signature