[Hospital Name] [HospitalAddress]

Approximate In-patient Part Bill

Patient Name : [PatientName] Patient ID : [OPNo] Nursing Station : [NursingStation] Bed : [Bed]

Your approximate balance as on [PDate] to [rupees] [Amount]/-. Kindly clear the amount at the earliest.
		Thanking You
[PrintDate]		[UserName]
		Receptionist/Cashier