HOSPITAL BILL
Bill No: 205526 Bill Date:22-04-24
Andrew s Cunningham
Name of Patient________________________________________________________________, M
Age/Sex______,
Address_____________________________________________________________________________________,
VARYANT YOLU ÜZERİ ZONTUR İŞHANI Antakya
Date / Time of Admission_05-04-2024, 04:23 Date / Time of Discharge nil
Name of Treating Doctor___DR.Tekinay Iscan, Department__Istanbul,
Accommodation Type: HOSPITAL ACC, Room No_NİL__,
Diagnosis: ICD IMPLATATION.
Code Billing Heads Rate Quantity Amount in Rs.
1 Room Rent
2 Nursing Charges
3 RMO Charges
4 IV Fluids Administration Charges $27
5 Blood Transfusion Administration Charges
6 Injection Charges
7 Similar expenses as Above
Total Room Rent Services
1 ICU Rent
2 ICU Nursing Expenses
3 ICU RMO charges
4 IV Fluids Administration Charges
5 Blood Transfusion Administration Charges
6 Injection Charges $13
7 Similar expenses as Above
Total ICU Services
1 Surgeon Charges $17,532
2 Anesthetist Charges
3 Medical Practitioner Charges $90
4 Consultants Charges
5 Specialist Charges $80
Total Professional Fee
1 Anesthesia
2 Blood $550
3 Oxygen
4 Operation Theater Charges
5 Surgical Appliances
Code Billing Heads Rate Quantity Amount
66 Medicines and Drugs $192
77 Diagnostic Materials
8 General Investigations
9 Specialized Investigations
10 Dialysis
11 Chemotherapy
12 Radiotherapy
13 Cost of Artificial Limbs
14 Cost of Implants $2178
Total of Other Expenses
Grand Total $20,662
Patient Paid Amount
Balance
Signature
