	[Hospital Name] [HospitalAddress]

[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 #	[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]
[Billother]	[BillOtherAmt]
Net Amount	[ActNet Amount]
Vat Amount	[Vat]
Cess Amount	[Cess]
Total Amount	[Net Amount]

Insurance /Corporate
Claimed Amount : [ClaimedAmount]
[Crupees]

Printed Date : [PrintDate]

Signature & Stamp

[UserName]

Cashier