JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Ashrafunnaher |
| Age / Gender: | 30 Yrs / Female |
| Mobile: | 01760445701 |
| Address: | Mesta |
| Invoice No: | LAB-26-0624 |
| Billing Date: | 11-09-2026 11:36 AM |
| Patient Type: | Outdoor |
Ref. Doctor:
Self
Ref. Patient:
Firoz Mia
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | CBC | 500.00 |
| 2 | Urine for R/M/E | 300.00 |
| 3 | Random Blood Sugar | 150.00 |
| 4 | Hbs Ag | 500.00 |
| 5 | FT4 | 1,500.00 |
| 6 | TSH | 1,000.00 |
| 7 | USG Pregnancy Profile / Uterus & Adnexa | 1,000.00 |
| 8 | Edta Tube | 30.00 |
| 9 | Red Tube | 30.00 |
| 10 | Collection Set | 25.00 |
| 11 | Urine pot | 25.00 |
| Subtotal: | 5,060.00 BDT |
| Discount: | - 0.00 BDT |
| Grand Total: | 5,060.00 BDT |
| Money Received (Paid): | 1,000.00 BDT |
| Due: | 4,060.00 BDT |
Patient / Guardian Signature
Authorized Signature