Priya Mahadevan
Patient ID: LBH-2024-PT-7842
Age / Gender: 34 Years / Female
Contact: +91 98765 43210
Email: [email protected]
Address: 42, South Street, Mylapore, Chennai
Invoice Number: LBH/INV/2024/1847
Invoice Date: July 8, 2024
Admission Date: July 5, 2024
Discharge Date: July 8, 2024
Payment Due: July 23, 2024
Ward/Room: Suite 301, Tower B
| Service Description | Doctor/Specialist | Date | Amount (₹) |
|---|---|---|---|
| Initial Consultation - General Medicine | Dr. Rajesh Kumar, MD | Jul 5, 2024 | 1,500.00 |
| Cardiology Specialist Referral | Dr. Meenakshi Nair, DM Cardiology | Jul 5, 2024 | 2,000.00 |
| Neurology Consultation | Dr. Anand Sharma, MD, DM Neurology | Jul 6, 2024 | 2,200.00 |
| Procedure Charges - ECG | Dr. Meenakshi Nair | Jul 5, 2024 | 450.00 |
| Procedure Charges - 2D Echo | Dr. Meenakshi Nair | Jul 6, 2024 | 3,500.00 |
| Subtotal - Doctor Services | 9,650.00 | ||
| Test Name | Category | Report Date | Amount (₹) |
|---|---|---|---|
| Complete Blood Count (CBC) | Hematology | Jul 5, 2024 | 450.00 |
| Lipid Profile | Biochemistry | Jul 5, 2024 | 650.00 |
| Thyroid Function Test (T3, T4, TSH) | Endocrinology | Jul 5, 2024 | 850.00 |
| HbA1c (Glycated Hemoglobin) | Biochemistry | Jul 5, 2024 | 550.00 |
| Vitamin D3 & B12 | Specialized | Jul 6, 2024 | 1,800.00 |
| MRI Brain with Contrast | Radiology | Jul 7, 2024 | 8,500.00 |
| CT Chest Scan | Radiology | Jul 6, 2024 | 5,200.00 |
| Subtotal - Laboratory Services | 18,000.00 | ||
| Medicine / Item | Dosage | Qty | Amount (₹) |
|---|---|---|---|
| Cardivas 25mg (Carvedilol) | 1-0-1 | 30 tabs | 480.00 |
| Thyronorm 75mcg (Levothyroxine) | 1-0-0 | 30 tabs | 320.00 |
| Neurobion Forte Strip | 1-0-1 | 20 tabs | 280.00 |
| Shelcal 500mg (Calcium) | 1-0-0 | 30 tabs | 420.00 |
| Injection - Methylprednisolone 500mg | IV | 3 vials | 1,350.00 |
| Injection - Ondansetron 8mg | IV | 4 vials | 560.00 |
| IV Fluids - Normal Saline 500ml | IV | 6 units | 420.00 |
| Disprin Extra (Strip) | SOS | 1 strip | 35.00 |
| Subtotal - Pharmacy | 3,865.00 | ||
Accepted Payment Methods
Note: Payment is due within 15 days of invoice date. Please include invoice number in all payment references. For insurance claims, kindly submit the original invoice along with the claim form.