JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Suraiya |
| Age / Gender: | 45 Yrs / Female |
| Mobile: | 01743232411 |
| Address: | Madergonj |
| Invoice No: | LAB-26-0837 |
| Billing Date: | 25-09-2026 11:51 AM |
| Patient Type: | Outdoor |
Ref. Doctor:
Dr.Rumana Afroz MBBS.BCS.(Health) FCPS Gyne
Ref. Patient:
Hp
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | CBC | 500.00 |
| 2 | Urine for R/M/E | 300.00 |
| 3 | FT4 | 1,500.00 |
| 4 | TSH | 1,000.00 |
| 5 | Pelvic Organ | 1,200.00 |
| 6 | Collection Set | 25.00 |
| 7 | Edta Tube | 30.00 |
| 8 | Urine pot | 25.00 |
| Subtotal: | 4,580.00 BDT |
| Discount: | - 1,580.00 BDT |
| Grand Total: | 4,580.00 BDT |
| Money Received (Paid): | 3,000.00 BDT |
Patient / Guardian Signature
Authorized Signature