JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Rikta |
| Age / Gender: | 27 Yrs / Female |
| Mobile: | 01717334705 |
| Address: | vatara Jamalpur |
| Invoice No: | LAB-26-1167 |
| Billing Date: | 17-10-2026 04:05 PM |
| Patient Type: | Outdoor |
Ref. Doctor:
Dr.Dil Afrose Nisha MBBS (DU).BCS (Health) FCPS (Gynae&Obs)
Ref. Patient:
Firoz Mia
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | TSH | 1,000.00 |
| 2 | FT4 | 1,500.00 |
| 3 | T3 | 1,000.00 |
| 4 | Collection Set | 25.00 |
| 5 | Edta Tube | 30.00 |
| Subtotal: | 3,555.00 BDT |
| Discount: | - 1,555.00 BDT |
| Grand Total: | 3,555.00 BDT |
| Money Received (Paid): | 2,000.00 BDT |
Patient / Guardian Signature
Authorized Signature