Patient's Invoice
INVOICE#5669626
Elite Hospital
E 104, Dharti-2,
Nr' Viswakarma Temple,
Talaja Road,
Bhavnagar - 364002
To,
Richard Nixon
E 104, Dharti-2,
Nr' Viswakarma Temple,
Talaja Road,
Bhavnagar - 364002
Invoice Date :23rd Jan 2017
Due Date :25th Jan 2017
| # | Item Name | Quantity | Charges | Total |
|---|---|---|---|---|
| 1 | Visiting Charges | - | $100 | $100 |
| 2 | Medicines | 10 | $100 | $1000 |
| 3 | X-ray Reports | 2 | $600 | $1200 |
| 4 | Other Charges | - | - | $300 |
Sub - Total amount: $1600
vat (10%) : $160
Total :$1760
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