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JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER

Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur  |  Mobile: 01314868020
Money Receipt
Patient Name: Nasima
Age / Gender: 32 Yrs / Female
Mobile: 01717
Address: Hashil bot tola,jamalpur
Invoice No: LAB-26-1054
Billing Date: 09-10-2026 11:41 AM
Patient Type: Outdoor
Ref. Doctor: Dr.Rumana Afroz MBBS.BCS.(Health) FCPS Gyne
Ref. Patient: Firoz Mia
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 S.Creatinine 500.00
6 FT4 1,500.00
7 TSH 1,000.00
8 USG Pregnancy Profile / Uterus & Adnexa 1,000.00
9 Collection Set 25.00
10 Edta Tube 30.00
11 Urine pot 25.00
Subtotal: 5,530.00 BDT
Discount: - 1,530.00 BDT
Grand Total: 5,530.00 BDT
Money Received (Paid): 4,000.00 BDT
JAMALPUR DOCTOR HOSPITAL • DIAGNOSTIC CENTER •
PAID
Patient / Guardian Signature
Authorized Signature
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