[Hospital Name]

[HospitalAddress]
[Billtype][Cusname]
[DuplicateBill]
Patient Name : [PatientName] Age/Gender : [Age]
Patient No : [Patient Id] Doctor : [doctor]
Address : [Address] Department : [department]
Bill No :[Bill No] Bill Date : [Bill Date]
Customer [Customer] Bed : [bed]
Bed No : [bed] Nursing Station :[NURSTATION]
Drug Lic No : [Drug Lic No]
[item List]
[Remarks]
Gross Amount [gross]
Discount [Discount]
[Billother] [BillOtherAmt]
Net Amount [ActNet Amount]
GST [GSTAmt]
CGST [CGST]
SGST [SGST]
CESS [CESS]
Tax Amount [TaxAmt]
Total Amount [Net Amount]
Non insured Amount [noninsamt]
Less Advance [Adavnce Amount]
Patient Payable [Payable Amount]
Claimed Amount [ClaimedAmount]
In Words:[rupees]
Claimed Amount In Words:[Crupees]
Billed by Checked By Dispersed By

[UserName]

[Outlet]

[Counter]

Printed Date : [PrintDate]