JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Debi |
| Age / Gender: | 50 Yrs / Female |
| Mobile: | 017 |
| Address: | Shamgong Kalibari |
| Invoice No: | LAB-26-1181 |
| Billing Date: | 18-10-2026 03:33 PM |
| Patient Type: | Outdoor |
Ref. Doctor:
Dr.Shamim Reza MBBS,BCS,D-ortho FCPS
Ref. Patient:
Dilip Modok
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | Uric Acid | 600.00 |
| 2 | RA | 800.00 |
| 3 | X-Ray Hip Joint B/ View | 1,400.00 |
| 4 | Edta Tube | 30.00 |
| 5 | Red Tube | 30.00 |
| 6 | Collection Set | 25.00 |
| Subtotal: | 2,885.00 BDT |
| Discount: | - 0.00 BDT |
| Grand Total: | 2,885.00 BDT |
| Money Received (Paid): | 0.00 BDT |
| Due: | 2,885.00 BDT |
Patient / Guardian Signature
Authorized Signature