JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Mahmuda |
| Age / Gender: | 27 Yrs / Female |
| Mobile: | 01967557009 |
| Address: | tetulia jamalpur |
| Invoice No: | LAB-26-1000 |
| Billing Date: | 04-10-2026 05:28 PM |
| Patient Type: | Outdoor |
Ref. Doctor:
Self
Ref. Patient:
md
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | FT3 | 1,500.00 |
| 2 | FT4 | 1,500.00 |
| 3 | TSH | 1,000.00 |
| 4 | Edta Tube | 30.00 |
| 5 | Red Tube | 30.00 |
| 6 | Collection Set | 25.00 |
| Subtotal: | 4,085.00 BDT |
| Discount: | - 0.00 BDT |
| Grand Total: | 4,085.00 BDT |
| Money Received (Paid): | 0.00 BDT |
| Due: | 4,085.00 BDT |
Patient / Guardian Signature
Authorized Signature