[Hospital Name]

[HospitalAddress]

IP DEPOSIT RECEIPT
[PatientName] Patient No [Patient Id]
[Age] Invoioce No [Advance No]
[Address] Date [Advance Date]
IP No [IPNo]
Doctor Dr [Doctor]
Department [Department]
Admitted Date :[Admitted Date] Bed [Bed]
Amount in Rupees
[item List]
[rupees] Total
[Total]
Recieved with thanks from [PatientName]

Remarks : [Remarks]
Prepared By :[user] Counter :[counter] Cashier