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JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER

Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur  |  Mobile: 01314868020
Money Receipt
Patient Name: Laboni
Age / Gender: 28 Yrs / Female
Mobile: 01710421695
Address: baipas
Invoice No: LAB-26-0627
Billing Date: 11-09-2026 01:43 PM
Patient Type: Outdoor
Ref. Doctor: Self
Ref. Patient: Hp
SL Test Name Price (BDT)
1 Hb% 200.00
2 Urine for R/M/E 300.00
3 Random Blood Sugar 150.00
4 Hbs Ag 500.00
5 Red Tube 30.00
6 Edta Tube 30.00
7 Collection Set 25.00
8 Urine pot 25.00
Subtotal: 1,260.00 BDT
Discount: - 0.00 BDT
Grand Total: 1,260.00 BDT
Money Received (Paid): 0.00 BDT
Due: 1,260.00 BDT
JAMALPUR DOCTOR HOSPITAL • DIAGNOSTIC CENTER •
DUE
Patient / Guardian Signature
Authorized Signature
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