JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Faria Jaman Urmi |
| Age / Gender: | 21 Yrs / Female |
| Mobile: | 01 |
| Address: | Titpalla |
| Invoice No: | LAB-26-0737 |
| Billing Date: | 18-09-2026 12:49 PM |
| Patient Type: | Outdoor |
Ref. Doctor:
Dr.Rumana Afroz MBBS.BCS.(Health) FCPS Gyne
Ref. Patient:
Faruk marketing
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | FT4 | 1,500.00 |
| 2 | TSH | 1,000.00 |
| 3 | Collection Set | 25.00 |
| 4 | Edta Tube | 30.00 |
| Subtotal: | 2,555.00 BDT |
| Discount: | - 0.00 BDT |
| Grand Total: | 2,555.00 BDT |
| Money Received (Paid): | 0.00 BDT |
| Due: | 2,555.00 BDT |
Patient / Guardian Signature
Authorized Signature