[Billtype]
[DuplicateBill]
Drug Lic No [Drug Lic No] Tin No [Tin No]
Patient ID [Patient Id] Token No [Token]
Patient Name [PatientName]   [Age] Address [Address]
Bed No [bed] Doctor [doctor]
Bill No [Bill No] Department [department]
Bill Date [Bill Date] Patient Type [Ptype]
[item List]
Non insured Amount [noninsamt]
Less Advance [Adavnce Amount]
Patient Payable [Payable Amount]
Cash [Cash]
In Words :  [rupees]
Gross Amount [gross]
Discount [Discount]
Net Amount [ActNet Amount]
Tax Amount [Vat]
Cess Amount [Cess]
Total Amount [Net Amount]
Insurance /Corporate
Claimed Amount : [ClaimedAmount]
Rupees : [Crupees]

Printed Date : [PrintDate]

Signature & Stamp

[UserName]

Cashier