[HospitalName]

[HospitalAddress]
ROOM/BED ALLOTMENT SLIP (R/ACC-16/0)
[PatientDetails]
[Details1]
[Details2]





Dates:[Dates] Receptionist




N.B : The checkout time is 3.00:00 PM.Those who stay
beyond that time on the day of discharge will
have to pay one day's extra rent. Signature