JAMALPUR DOCTOR HOSPITAL & DIAGNOSTIC CENTER
Advanced Diagnostic & Pathology Services
Modhupur Road, Jamalpur | Mobile: 01314868020
Money Receipt
| Patient Name: | Forid |
| Age / Gender: | 30 Yrs / Male |
| Mobile: | 01718685462 |
| Address: | Hajipur,jamalpur |
| Invoice No: | LAB-26-1259 |
| Billing Date: | 23-10-2026 11:22 AM |
| Patient Type: | Outdoor |
Ref. Doctor:
Self
Ref. Patient:
Firoz Mia
| SL | Test Name | Price (BDT) |
|---|---|---|
| 1 | FT4 | 1,500.00 |
| 2 | TSH | 1,000.00 |
| 3 | Random Blood Sugar | 150.00 |
| 4 | HBA1c | 1,200.00 |
| 5 | Collection Set | 25.00 |
| 6 | Edta Tube | 30.00 |
| 7 | SGPT | 600.00 |
| 8 | CXR P/A | 700.00 |
| Subtotal: | 5,205.00 BDT |
| Discount: | - 2,055.00 BDT |
| Grand Total: | 5,205.00 BDT |
| Money Received (Paid): | 3,150.00 BDT |
Patient / Guardian Signature
Authorized Signature