Scribd
Upload
18 views7 pages

MalarMedicak Invoice

Uploaded by

RAASHINI A/P PRABAGARAN Moe
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
18 views7 pages

MalarMedicak Invoice

Uploaded by

RAASHINI A/P PRABAGARAN Moe
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF or read online on Scribd
You are on page 1/ 7
" 398, Jalan Abdul Samad, 80100 Johor rere Erewee ates Srromusrroserae (Roaistrd a Johor Spoil Hoop Sabha: Regn Ne: 45360: SHOMRINVOICE Heese PAGE: 1 INV NO: 4609671 BILL No: 4609671 USER-ID: Z.NAFTSA DEBTOR: 820111015314 BILL DATE: 13/05/2023 12:14 NAME: PUSFAMALER A/P BALAKRISHVAN BPISODE TYPE: oUDPATIENT 4 SUN TEMBuSU, EIN CLASS: pr TN SRI PLENTONG BILL TYPE: op 82750 MRSAT JOHOR DARUL TaKzrH CREDIT TERM: Casi PATIENT: 708943 — oogo7 “1 NAKE: PUSPAMRLER A/P BALAKRISHNAN NO 4 JALAN TEMBUSU, TANAN SRI PLENTONG waged 81750 MASAT JOHOR DARUL tAKeIN 13/05/2023 / 0852 13/05/2023 7 12214 PR MOHANRAJ KRISHNASAMY MASAI AMOUNT (RM) TAX AMP (RM) PAYABLE Aw? (RM) consuntanr DR MOHAWRAI KRISHNASAMY - consuLTAT 235.00 0.00 235.00 DR MOHANRAT KRISHNASAMY — PRocELURE 230.00 0:00 230.00 suB TorAL, 465.00 HOSPrTan AOMINSTRATIVE FEES 9.00 NURSING PROCEDURE 10-09 PHARMACY TEN 85.55 SURGICAL/MEDICAL SUPPLIES 7.60 SUB TorAL, 112.15 TOTAL BILL AMOUNT 577.15 DEPOSIT/enYMENT PAID: RC ‘INP1-000080587 13/05/2023 577.15 TOTAL AMOUNT 0 BE PAID / (REFUND) 0.00 BILLER cove: 44800 REF 1: 4609671 REF 2: : 80100 Johor Bahru, Johor. {er seb7225 2000 (0 ie] ran sarod ots ocean Vioate wmnjoercon Ena so rofeathcon my essa aa (Geto a2 Woh Splat Hotpal Sa. Regn orricrar Meee sy Payer fcasH Receipt No : INP1-o000sese7 Aaee Nome? PUSPAMALER A/P BALAKRISHNAN Date 13/05/2023 Address: Time 12:14 Cashier Z.NAFISA Bay By PBB-VISA Amount 577.15 Being payment received for: Description Amount Tax Ant Total Amount Tax Code Tramanvoise No 4609671 dated 13/05/2023 877.15 577.15 (Wane: PUSFAMBLER 2/P BALAKRISHNAN Mi/Ep ion 708943/7) TOraL Reference + $0784/733/806 Renark. cash Bill Rrint Date/Time : 13/05/2023 12:14 Additionel Line of Receipt /Depoaie/nefund/CR/oN seecenwworce *#00e To: Name: PUSPAMALER A/P BALAKRISHNAN Invoice No: 4609672 4 OLN TEMaUSD, Adm. Date/Time: 13/05/2023 / 0852 ‘TWN SRI PLENTONG Disch. Date/Time: 13/05/2023 / 12:14 81750 MASAI JOHOR DARUL TAKZIM No of Day Stay: 0 Postcode: 00000 Inv. Date: 13/05/2023 0708943 - 007 Ward/Bed: / : 820111-01-5314 PUSPAMALER A/P BALAKRISHNAN Admit. Doctor: pros No 4 JALAN TEMBUSU, TAMAN SRI PLENTONG 81750 MASAI JOHOR DARUL TAKZIM Postcode: 81750 MASAT CONSULTANT Tex Amt Payable amt Tax Price Code Description Trans Date (au (BM) Code 96042020 DR _MOKANRAT KRISHNASAMY - CONSUL 13/05/2023 0.00 235.00 ruco3001specialist Fee : First visit / Initial consultat OR MOHANRAT KRISHNASAMY - cons 235.00 06042012 OR MOHAWRAT KRISHNASAMY - PROCED 13/05/2023 0.00 110.00 KMP47012Procedure and report 0604202 DR MOHANRAJ KRISHNASAMY - PROCED 13/05/2023 0.00 120.00 "+ No MMAMaster record is available. (91) HosPrTaL. 15020003 ADMINSTRATIVE FEES 13/05/2023 0.00 9.00 ADMINSTRATIVE FEES 9.00 Page: 1 Tax Ant Payable amt Tax Price Code Description Trans Date (ae) (RN) Code 51200246 SODIUM CHLORIDE 0.9% 10ML INI 13/05/2023 0.00 4.00 51200689 DYNASTAT 40MG/2ML INJ (PARECOXTB 13/03/2023 0.00 81.55 PEARMACY ITEM 85.55 52121586 ALCOHOL SWAB NUR CARE (GDO001) 13/08/2023 0.00 0.50 52374477 NITRILE EXAM GLOVES PF - SIZES 13/08/2023 0:00 iio 52420055 NEEDLE 186 X 1 1/2" TERUMO (NN*1 13/08/2023 0:00 2:00 52420072 NEEDLE 256 x $/8" TERUMO (NN*251 13/05/2023 0:00 2:00 52420133 SYRINGE BD 3c¢ 13/05/2023 0:00 200 SURGICAL/MEDICAL SUPPLIES 7.60 53020037 INJECTION - OUT PATIENT 13/05/2023, 0.00 10.00 NURSING PROCEDURE 10.00 Group Total 112.15 Total Bill Amount 577.15 Deposit Paid 577.15 Total Amount To Be Paid / (Refund) 0:00 nore A) ERROR AND OMISSION EXCLUDED. 8) INTEREST WILL BE CHARGED ON OVERDUE ACCOUNT AT THE RATE OF 1.5 PER MONTH. ©) COMPUTER GENERATED DOCUMENT DOES NOT NEED ANY SIGNATURE 398, Jalan Abdul Samad, 80100 Johor Bahru, Johor “ek 1607-225 3000 (50 Lines) Fax: +607-224 8213. ‘SreCuLieT noReTAL \iebsite: vavizkpjonor.com E-mal:[email protected])heath com my 7 (Registered as :Uotior Specialist Hospital Sdn. Bh. Regn No : 45363-X) mw wo: 4611779 BILL No: 461179 USER-ID: NORDIZA, DEBTOR: 20600044013 BILL DATE: 17/05/2023 11:30 NAME: MEDIEXPRESS (tM) SDN BHD ~ AXA EPISODE TYPE: INPATIENT P-G-7,BLOCK F, PUSAT KOMERSTAL FIN CLASS: HCO, PARKLANE, NO 21, JALAN 887/26 BILL Tyee: Te 47301 KELANA Java, CREDIT TERM: 30 oaYS panzer: 708943 ~ 00008 WARD/BED: MRI/32-1/719-8 NAME: PUSPANALER A/P BALAKRISHNAN ADM DATE/TIME: 13/05/2023 / 19:40 No 4 JALAN TEMBUSO, DISCH DATE/TIME: 17/05/2023 / 11:30 STRMAN SRI. PLENTONG LENGTH OF STAY: 4 81750 81750 MASAT JOHOR DARUL TAKZIM OMITTED BY: DR MOHANRAS KRISHNASAMY MASAI AMOUNT (RON) TAX AMT (RM) BRYABLE ANT. (RK consuurant 2 [DR KIRAN NAIR A/P HK BASKARAN NAIR 20.00 0.90 A 20-00 DDR MOHANRAY KRISHNASAMY ~ CONSULTAT 350.00 0:00 232528 DR MOHANRAY KRISHNASAMY - PROCEDURE 90:00, 0.00 alti WA "90:00 DR MOHANRAY KRISHNASANY - SURGERY 5,182.50 Wishz22:s0 DR MOHAMRAG KRISHNASAMY — WARD REVI 340.00 14000, DR TAY LEE SAN ~ ANAESTHETIST 2,058.00 Ys :00 DR TAY LEE SAN - CONSULTATION Docro 350-00 “2380.00 DR TAY LEE SAN - PROCEDURE 130700, Ge0:00 DR TAY LEE SAN ~ WARD REVIEW 300.00 300.00 DR ZAHARI MAHBAR ~ PROCEDURE 6:00, 6:00, DR ZAHART HAHBAR - REPORTING FEE 13150 1350, vB TOTAL 9,337.00 HoserzaL ‘ADMINSTRATIVE FEES 5.00 9.00 9.00 DIAGNOSTIC. THAGING 40,00 0:00 90:00, DISCOUNT-CORPORATE. Teal 0-00 188200, DOUBLE BEDDED (EW) @ 4 nays! «80°00 0:00 480.00 ECG ~ LONG LEAD (PKG) 60.00 0:00 ‘60.00 LABORATORY 4, 160:00 0:00 1,160.00, MEDICAL BOUEHENT 721.00 0100 72100 BORSING PROCEDURE 82800 0:00 828,00 ‘OPERATION THEATRE 4,880.00 0:00 1,880.00, PAARMACY 53.23, 0:00 93:28 PHARMACY TTeH 2,541.06 0:00 2,541.06 REGISTRATION-INSURANCE 60.50, 0:00 60:50, Rou DISCOUNT: -18200, 0:00 152/00 STERILE SUPPLIES 556.00 0:00 556.00, SURGICAL/MEDICAL SUPPLIES 2,521.10 0:00 2,821.10, PHAR TAKE AWAY 153150 0:00 153°50 0B TOTAL 10,723.45, 0.00 10,723.45 TOTAL BILL AMOUNT 20,060.45 DEPOSIT/PAYMENT PAID: ow cen-225805 22/08/2023, 200.00 TOTAL AMOUNT TO BE PAID / (REFUND) 19,860.45 notes: R) This may not be a final bill unless you do not hear from us within seven (7) days B) Interest will be charged on overdue account at the rate of 1.5 pe month ©) Computer generated docunent does not need any signature D} Effective 1st Septenber 2018, Hospital & Specialist Consultant charges are not subject to Service Tax 2018 seecemwvorce #H+++ PAGE: 1 INV No: 4611779 BILL NO: 4621779 USER-ID: NORDIZA + 20600044013, BILL DATE: 17/05/2023 11:30 MBDIEXPRESS (M) SDN BHD - AXA. EPISODE TYPE: INPATIENT P-G-7,BLOCK F, PUSAT KOMERSTAL FIN CLASS: MCO PARKLANE, NO 21, JALAN 837/26 BILL TYPE: IP 47301 KELANA JAYA, CREDIT TERM: 30 DAYS SELANGOR.D.E PATIENT: 708943 "- "00008 WARD/BED: MAT/B2-N/719-B NAMB: PUSPAMALER A/P BALAKRISHNAN ADM DATE/TIME: 13/05/2023 / 19:48 No 4 JALAN TEMBUSU, DISCH DATE/TIME: 17/05/2023 / 11:30 TAMAN SRI PLENTONG LENGTH OF STAY: 4 81750 81750 MASAI JOHOR DARUL TAKZIM ‘ADMITTED BY: DR MOHANRAT KRISHNASAMY MASAI AMOUNT (RM) TAX AMT. (RM) PAYABLE AMT (RM) CONSULTANT DR KIRAN NATR A/P MK BASKARAN NAIR 20.00 0.00 20.00 DR MOHANRAS KRISHNASAMY ~ CONSULTAT 350.00, 0.00 350.00, DR MOHANRAS KRISHNASAMY ~ PROCEDURE 3000 0.00 90.00 DR MOHANRA KRISHNASAMY ~ SURGERY 5,182-50 0.00 5,182.50, DR MOHANRA KRISHNASAMY - WARD REVI 840.00 0.00 840.00 DR TAY LEE SAN - ANAESTHETIST 2,055.00 0.00 2,055.00 DR TAY LEE SAN - CONSULTATION pocTo 350-00 0.00 350.00 DR TAY LEE SAN - PROCEDURE 130/00 0:00 330.00 DR TAY LEE SAN - WARD REVIEW 300:00 0.00 300.00 DR ZAHART MAHBAR - PROCEDURE 6.00 0.00 6.00 DR ZAHARI MAHBAR - REPORTING FEE 13:50 0:00 13.50 SUB TOTAL HOSPITAL ADMINSTRATIVE FEES 9.00 0.00 9.00 DIAGNOSTIC IMAGING 90:00 0.00 80.00 DISCOUN?-CORPORATE -188 00 0.00 -188. 00 DOUBLE BEDDED (NEW) @ 4 DAYS 480-00 0.00 480.00 ECG - LONG LEAD (PKG) 60.00 0.00 60:00 LABORATORY 1,160.00 0:00 1,160.00 MEDICAL EQUIPMENT 721/00 0.00 721.00 NURSING PROCEDURE, 828/00 200 828.00 OPERATION THEATRE 1,880.00, 0.00 1,880.00 PHARMACY 53.29 0:00 53.28 PHARMACY TTEM 2,541.06 0:00 2,541.06 REGISTRATION-INSURANCE 60.50 0.00 60.50, ROOM DISCOUNT: 192/00, 0:00 192/00, STERILE SUPPLIES 556.00 0:00 556.00 SURGICAL/MEDICAL SUPPLIES 2,521.10 0:00 2,521.10 PHAR TAKE AWAY 0:00 153.50 SUB TOTAL, 40,723.45 0.00 10,723.45 TOTAL BILL AMOUNT 20,060.45 DEEOSIT/PAYMENT PAID: on en-225505, 22/08/2023 200.00 (Unattocated) RD ADMS-000056323, 13/08/2023 20:00 TOTAL AMOUNT TO BE PAID / (REFUND) 19, 660.45 ores: A) This may not be a final bill unless you do not hear from us within seven (7) days. B) Interest will be charged on overdue account at the rate of 1.5% per month. ©) Computer generated document does not need any signature D) Effective Ist September 2018, Hospital & Specialist Consultant charges are not subject to Service 7 ax 2018, JOMPAY : BILLER cope: 44800 REF 1: 4611779 2

You might also like