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APOLLO HOSPITALS EMERGENCY 1066

Opposite IIMB,154/11, Amalodbhavi Nagar, Panduranga Nagar,


Bangalore - 560076 (India)
Tel.: +(91)-80-26304050 / 26304051 Fax: +(91)-80-41463151

INPATIENT BILL
PATIENT DETAILS IP No. : 97101 ID No. : 0000246611

Saravana kumar V Bill No. : ICR33504

A2 Nagesan nagar Bill Dt./Time : 13-Jan-2013 10:06 AM


Vadalur
Cuddalore taluk Admission Dt./Time : 10-Jan-2014 7:22 AM
TamilNadu
Discahrge Dt./Time : 13-Jan-2014 10:06 AM

DETAILS
Service Name Amount(Rs.)

ROOM RENT 4,000.00


PHARMACY 2,765.54
MEDICAL EQUIPMENT 1,000.00
CONSULTATIONS 2,400.00
CONSUMABLES 2,118.00
INVESTIGATIONS 2,860.00

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Bill Amount 15,143.54


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In Words :
Fifteen Thousand Hundred Forty Three Rupees and Fifty Four Paise.

Refundable Deposit As On 13-Jan-2014 10:05 AM Rs.5000

This is a computer generated statement and requires no signature.

This Receipt is valid for an employer or insurer, who is contractually obligated to reimburse the medical expenses covered by MediSave
and/or MediShield.

For billing and general enquiries, please mail: customercare_bangalore@apollohospitals.com

© Apollo Hospitals, Bangalore 2013, All Rights reserved