Jack Doe (1234567890)
Male - 64 year - B +ve
Dr. John Doe Surgery (NS OPD 2)
Apt. ID - 372439
Admit ID - 405588
Patient Billing Code
GEN
Payment Priority
1 C.C 2 Ins
Suftansa Insurance Safe Suftansa Pack Insurance coverage

฿1000.00 per day

Note Alert

3

Luis Hall

PID 562588

Dr. Sateesh Talpade

Lorem id natoque in elementum velit. Lorem facilisi sit id est, cras commodo. Id dignissim at elit cras mattis nulla lacus quam.

15 min ago

High Valid for this visit only

Dr. Sateesh Talpade

Lorem id natoque in elementum velit. Lorem facilisi sit id est, cras commodo.

15 min ago

Medium Valid for this visit only

Dr. Sateesh Talpade

Morbi est nisl at integer potenti tincidunt. Eget vel ac quis arcu lacus cras dui, a enim. Nam lectus arcu, ultrices egestas malesuada tempor luctus. Commodo lectus dui pellentesque dictumst. Est in tincidunt etiam.

07-07-2022, 10:10 AM

Low From 07-07-2022 to 14-07-2022

Service/Item Distribution

Income Type Catalog Price (฿) Billable Amount (฿)
1.1.1 Drugs and Parenteral Nutrition
3 S.P
2204.22 2168.06 arrow_drop_up
# Order No. Order Origin Date of Service Time Items / Services Allocate DF to (Doctor) Qty Catalog
Price (฿)		 Discount /
Addition (฿)		 VAT(7%) Billable
Amount (฿)
01 BC32456 NS OPD 26-03-2020 05:40 Wound Dressing Dr. Jim Reid 1 562.10 -56.10 39.34 533.88
02 BC65243 NS OPD 26-03-2020 06:44 Procedure name A Dr. Chad Warner 1 747.29 -74.29 N/A 673.00
03 NSB7881 DR OPD 26-03-2020 10:49 Metformin N/A 3 550.00 N/A N/A 550.00
04 BC32456 DR OPD 26-03-2020 16:57 Paracetamol DF Not Setup 4 350.00 N/A N/A 350.00
05 BC32456 NS OPD 26-03-2020 19:49 LFT N/A 1 544.83 N/A 38.13 582.96
1.1.3 Blood Transfusion Services
1 C.C
3172.82 3132.85 arrow_drop_up
# Order No. Order Origin Date of Service Time Items / Services Allocate DF to (Doctor) Qty Catalog
Price (฿)		 Discount /
Addition (฿)		 Billable
Amount (฿)
01 BC32456 NS OPD 26-03-2020 05:40 Wound Dressing Dr. Jim Reid 1 562.10 -28.10 534.00
BC65243 NS OPD 26-03-2020 06:44 Procedure name A N/A 1 747.29 -37.29 762.31
Cancellation Note: Diam dui in elementum lectususto
nisl, ipsum sem lacus ut arcu tortor. Know More
03 NSB7881 DR OPD 26-03-2020 10:49 Metformin N/A 1 551.89 -26.89 525.00
04 BC32456 NS OPD 26-03-2020 16:57 Chest X-Ray PA Dr. Lee Johnston 1 766.71 N/A 766.71
05 BC32456 DR OPD 26-03-2020 19:49 LFT Dr. Emma Collins 1 544.83 N/A 544.83
1.1.5 Drugs and Parenteral Nutrition
2 INS
1861.28 1808.34 arrow_drop_up
# Order No. Order Origin Date of Service Time Items / Services Allocate DF to (Doctor) Qty Catalog
Price (฿)		 Discount /
Addition (฿)		 Billable
Amount (฿)
01 BC32456 NS OPD 26-03-2020 05:20 Chest X-Ray PA Dr. Jim Reid 1 562.10 -28.10 573.34
02 BC65243 NS OPD 26-03-2020 11:25 LFT N/A 1 747.29 -37.29 710.00
03 NSB7881 DR OPD 26-03-2020 11:25 LFT Dr. Stanley Fowler 1 551.89 -26.89 525.00
1.1.14 (1) Lorem Ipsum Medical Package
99,600 89,600 arrow_drop_up
# Order No. Order Origin Date of Service Time Items / Services Allocate DF to (Doctor) Qty Catalog
Price (฿)		 Discount /
Addition (฿)		 VAT(7%) Billable
Amount (฿)
01 - NS OPD 26-03-2020 05:20 MP Knee Replacement (Custom : V... Dr. Jim Reid 1 89,000 - - 89,000.00
View Print
02 - NS OPD 26-03-2020 11:25 MP Physiotherapy (Custom : Visit 2) N/A 1 10,000 - - 00.00
View Print
03 NSB7881 DR OPD 26-03-2020 10:49 Chest Xray Dr. Stanley Fowler 2 600.00 - - 600.00
View Print
Total (฿) 1,06,488 -3600 315 96,709
1
Microsoft C.C
01-12-2018 to 31-12-2019 50000
60,000 -1200 600 50,000
2
Aviva INS
01-12-2018 to 31-12-2019 40000
40,000 -1200 600 40,000
3
Self Pay S.P
10,000 -1200 600 9,350
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