JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Chaya Modok |
| Age / Gender: | 80 Yrs / Female |
| Mobile: | 01 |
| Address: | Madergonj |
| Invoice No: | LAB-26-1065 |
| Billing Date: | 09-10-2026 12:21 PM |
| Patient Type: | Outdoor |
Ref. Doctor:
Dr.Mohammad Mohsin MBBS,BCS(Health)MD Medicine MACP
Ref. Patient:
Dilip Modok
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | CBC | 500.00 |
| 2 | Random Blood Sugar | 150.00 |
| 3 | S.Creatinine | 500.00 |
| 4 | Electrolytes | 1,200.00 |
| 5 | IgE | 1,200.00 |
| 6 | Collection Set | 25.00 |
| 7 | Edta Tube | 30.00 |
| Subtotal: | 3,605.00 BDT |
| Discount: | - 0.00 BDT |
| Grand Total: | 3,605.00 BDT |
| Money Received (Paid): | 1,000.00 BDT |
| Due: | 2,605.00 BDT |
Patient / Guardian Signature
Authorized Signature