JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Roksana Riya |
| Age / Gender: | 23 Yrs / Female |
| Mobile: | 01934834146 |
| Address: | baipas |
| Invoice No: | LAB-26-1168 |
| Billing Date: | 17-10-2026 06:02 PM |
| Patient Type: | Outdoor |
Ref. Doctor:
Self
Ref. Patient:
md
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | OGTT | 400.00 |
| 2 | FT4 | 1,500.00 |
| 3 | TSH | 1,000.00 |
| 4 | Edta Tube | 30.00 |
| 5 | Collection Set | 25.00 |
| Subtotal: | 2,955.00 BDT |
| Discount: | - 1,155.00 BDT |
| Grand Total: | 2,955.00 BDT |
| Money Received (Paid): | 1,800.00 BDT |
Patient / Guardian Signature
Authorized Signature