JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Asha |
| Age / Gender: | 20 Yrs / Female |
| Mobile: | 01648137756 |
| Address: | Titpalla |
| Invoice No: | LAB-26-1215 |
| Billing Date: | 20-10-2026 03:55 PM |
| Patient Type: | Outdoor |
Ref. Doctor:
Dr.Dil Afrose Nisha MBBS (DU).BCS (Health) FCPS (Gynae&Obs)
Ref. Patient:
Dr,Selim
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | CBC | 500.00 |
| 2 | Urine for R/M/E | 300.00 |
| 3 | TSH | 1,000.00 |
| 4 | USG Pregnancy Profile / Uterus & Adnexa | 1,000.00 |
| 5 | Collection Set | 25.00 |
| 6 | Edta Tube | 30.00 |
| 7 | Urine pot | 25.00 |
| Subtotal: | 2,880.00 BDT |
| Discount: | - 1,180.00 BDT |
| Grand Total: | 2,880.00 BDT |
| Money Received (Paid): | 1,700.00 BDT |
Patient / Guardian Signature
Authorized Signature