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JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER

Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur  |  Mobile: 01314868020
Money Receipt
Patient Name: Jostna
Age / Gender: 20 Yrs / Female
Mobile: 01887610554
Address: N/A
Invoice No: LAB-26-0736
Billing Date: 18-09-2026 12:45 PM
Patient Type: Outdoor
Ref. Doctor: Self
Ref. Patient: N/A
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 Collection Set 25.00
8 Edta Tube 30.00
Subtotal: 4,005.00 BDT
Discount: - 5.00 BDT
Grand Total: 4,000.00 BDT
Money Received (Paid): 4,000.00 BDT
JAMALPUR DOCTOR HOSPITAL • DIAGNOSTIC CENTER •
PAID
Patient / Guardian Signature
Authorized Signature
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