[Hospital Name]

[HospitalAddress]
[Billtype]
[DuplicateBill]
Patient No [Patient Id] Doctor [doctor]
Patient Name [PatientName] Department [department]
Address [Address]
[contactno] 		Patient Type [Ptype]
Bill No [Bill No] Bed No [bed]
Bill Date [Bill Date] Ward [Ward]
[item List]
Patient
Non insured Amount [noninsamt]
Advance [Adavnce Amount]
Patient Payable [Payable Amount]
Rupees
[rupees]
Net Amount [Net Amount]
Gross Amount [Net Amount]
Discount [discount]
Insurance /Corporate
Rupees
[Crupees]
Printed Date : [PrintDate]   Signature & Stamp
[UserName]
 [Cashier]