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JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER

Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur  |  Mobile: 01314868020
Money Receipt
Patient Name: Rohem
Age / Gender: 42 Yrs / Male
Mobile: 01750474147
Address: N/A
Invoice No: LAB-26-0861
Billing Date: 26-09-2026 12:18 PM
Patient Type: Outdoor
Ref. Doctor: Self
Ref. Patient: N/A
SL Test Name Price (BDT)
1 X-Ray foot B/V 1,400.00
Subtotal: 1,400.00 BDT
Discount: - 0.00 BDT
Grand Total: 1,400.00 BDT
Money Received (Paid): 0.00 BDT
Due: 1,400.00 BDT
JAMALPUR DOCTOR HOSPITAL • DIAGNOSTIC CENTER •
DUE
Patient / Guardian Signature
Authorized Signature
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