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Invoices
Visit Date : 25-03-2020| # | Invoice No. | Ins. Company | Claim Note | Claimed Amt.(฿) | ||||||||||||||||||||||||||||||||||||||||||||||||||||
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| 01 | NSB7881 | Aviva |
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562.10 | attach_file | Attach Docs. | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 02 | BC65243 | TATA AIA |
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747.29 |
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| 03 | IN32456 | Aviva | 9000.00 |
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| 04 | BC32456 | TATA AIA | Add Note | 766.71 | attach_file | Attach Docs. | ||||||||||||||||||||||||||||||||||||||||||||||||||
| 05 | BC32456 | TATA AIA |
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544.83 |
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PID_154367-V1468_Aviva.pdf
Doctor Form
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Medical Certificate
1234567
Peadiatric
20-04-2020
I am Aric Bergnaum
Doctor who has the license no. 0
Has Performed Physical Examination of Mr. Theo James,
with Patient ID 85924
Diagnosis
Diagnosis
Diarrhea
Pneumonia
Comment
Confirm that the patient has come to the hospital for OPD treatment on Date - 01-12-2020
Appropriate for the Patient to rest/recover for 30 days from 01-01-2020 to 07-01-2020
Doctor's Signature
