	[Hospital Name] [HospitalAddress]
Balance Voucher

[Billtype]

[DuplicateBill]

Patient ID	: [Patient Id]	Contact No	: [contactno]
Patient Name	: [PatientName]	Department	: [department]
Bill No	: [Bill No]	Bill Date	: [Bill Date]
Age	:[Age]	Patient Type	: [Ptype]
Address	: [Address]	Doctor	:Dr. [doctor]
Customer	: [Cusname]
Bed	: [bed]	Nursing Station	: [NURSTATION]

GSTIN : [gstin]

Drug License No : [Drug Lic No]

Amount in : [currency]

[Item List]

Gross Amount	[gross]
Tax Amount	[GstAmt]
CGST	[CGST]
SGST	[SGST]
CESS	[CESS]
Discount	[Discount]
Net Amount	[Net Amount]
Patient Payable	[Payable Amount]
In Words :[rupees]
INSURANCE /CORPORATE
Claimed Amount	[ClaimedAmount]
[Crupees]

        [Remarks]
        

Counter

Billed by

[Outlet]

[Counter]

Printed Date : [PrintDate]

[UserName]