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Max Hospital Radiology Bill Receipt

This document is a bill of supply for medical services provided to Mr. Ajai Kumar Sangal, detailing a radiology service with a total amount of Rs. 528. The bill includes patient information, service details, payment mode, and company information. The payment was made via HDFC UPI on October 21, 2024.

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139 views1 page

Max Hospital Radiology Bill Receipt

This document is a bill of supply for medical services provided to Mr. Ajai Kumar Sangal, detailing a radiology service with a total amount of Rs. 528. The bill includes patient information, service details, payment mode, and company information. The payment was made via HDFC UPI on October 21, 2024.

Uploaded by

iitd.anshul
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

|MAX

Heaithcare
Billof Supply
Mobile No. : 9810215437 200426578
Patient Name : Mr. AJAI KUMAR SANGAL : 21/10/2024 12:23PM
BIUt Date
Age/Sex :69 years 9 months / Male :VSU.426578 | 200426578
Maxid SSN
Address : DL-8, AAT 604, ORANGE COUNTY
|VARCZ981393
APARTMENT BIII No | Receipt No : VACS3089932

GSTN BIN :RZ40D00002S7513


Emall ID [email protected]
GSTN NO : 09AACCCA239Q1Z6
PAN/ Form60
Referred By : Nishant Tyagi. Passport No

Company GSTN :
: AIRPORT AUTHORITY OF INDIA
Company Add. Company Name

Net Amnount Tax Amt BINAmoun


SI.N Services SAC Qty Base Tariff biscounts
Price(Rs.) (RS.) (Tax o) (Rs.)
Price(Rs.)
Radiology" (OPG) ( 999312 528.00 S28
660.00 132.0
By - Dr. Nishant
Tyagi.)
132.00 528.00 0.00 528.0
Total :

528.0
Pald by Patient
collected from patient
Amount in Words :Rupees five hundred twenty-eight only
Mr, AJAI KUMAR SANGAL
Sum Of Rs. 528.00 reoeived with thanks from
(Amount incudes discount (if any) as per Agreement )

Payment Mode(s)

HDFC UPI, Approval Code 349078900, Tr. ID-349078900,Dt-21-10-2024


UPI for RS.528.000(UPI No. :0, Card Name : Signature
12:00 ) Aart
Signature of Patlent/Next of Kin

PAN No. :AACCC4239Q


: Utar Pradesh-{ 09)
Place of Supply Ltd.)
Hospital-Vaishai (A unit of Cosslay Remedies
Company Name : Max Super Speciality

Crosslay Remedies Limited


Hospital, Vaishati Panchsheel Park,
Max SuperSpeciality Ltd)
Regd Office N 110,
Remedies
(A unit of Crossiay
New Deth1 10 017
UP
W3 Sector-1. Vaishal1, Ghaziabad- 201 012 T91 70424 01894
aithcare com E secretarialcrlomaxheaithcare com
E Into vsh@maxhe appointments
service queries or
For medicat RUYa aLugxhealthcare.com
please contact 9650749189,,emall;
4173 000
Cat 91.120 4188 000
feedbacks/suggestions, 1CIN UZ423
For any
www rn¥xhealthcare.in

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