Laboratory Bill for Patient in Word Format
Laboratory Bill for Patient in Word Format. Easy format of bill is given below,You can download this bill in word format.
Sample Laboratory Bill for Patient in Word Format
Laboratory Bill
| Lab InformationRegistration Location:____________Destination Location:___________Registration Date:__________ |
PATIENT BILL
| S.No. | Test Name | Reporting Date Time | Rate | ||
| 1 | BLOOD C/E (complete, CBC)Hb,WBC Count (TLC), DLC, Total RBC, Platelet count, MCV, MCH, MCHC, Type | Apr 02,2015-04-05 | 20:00 | 500.00 | |
| 2 | ESR | Apr 01, 2015-04-05 | 8:41 | 600.00 | |
| 3 | Vitamin | Apr 01, 2015-04-05 | 8:41 | 5000.00 | |
TOTAL BILL:
Total: 6100.00
Less/ Discount 100.00
| Paid: 6000.00 |
To be paid: 6000.00
Registered By: _____________
Collection Center:
Center Name: _______________
Phone no.____________
Fax no._____________
Contact Person: _____________
Address:__________________
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