Dr.Moopens Aster Hos| PO 24460, Matar Qadeem Doha, Qatar Tel: +974 44440499, www.aster qe emai admin@aster.aa Final Bill No (BOPR1803220004 ) Breakup To: SELF-FINALSETTLEMENT Bill No: Boprtsosz20004 —||I|MINAINITIIDNNIINIT Bill Date: 22.03.2018 UHID ‘AQHBO03670 Patient No: 0#18007286 QUT MO Patient Name: BERRIN PULLIKOTTIL BABU Age(Gender): 247 0M 12D (M) DOB: 11/03/1994 Pay Type: CREDIT OP: Bill Type: NORMAL Contact omen Date Of Opening 10/04/2018 01:29 Doctor: Dr-SiMI LALI Date Of Closing 10/04/2018 00:00 Deparment: INTERNAL MEDICINE sho |secprovOate| ser Service [NS] GessQAA) | Olsccunt_| PaLShae Net (QAR) puannacy + zaoszote—7oie2 WATER FOR MAP 2 ee as 2 anuanie teorieiows SODIUM CHLORIDE 06% OM BAG 1 aes as 8 manger 917A VOLTAREN SUP roaua 8s 1 oa os 4 angers nemo PANTAZOL AMG WAL es mas 5 zanvanne—ON4FOY TORADOL SOMME AMPOLREKETOROLAG} 1 shoo si 6 2n8a016 d7EOSI7A_ ONDANSETRON 2MGML 1 eso eon 1 zanvene 27388 BUSCOPAN 20MG ALN 1OSIENI 1 ss ass cconsuttaTion 1 zasz018 CONDO! EMERGENCY CONSULTATION 1 ar800 2s001 senwces 1 zaoszoie SEROST2 _INTRAVENOUGIM) NFUSION CHARGES 1 ts000 1en00 2 zanvante SERGE _NJECTION- NTRAVENOUSIV 1 1c000 tea00 Sno Account Head ‘Gross(QAR) Pal. Share(QAR) Discount(@AR) —_AMGAR) 1 senwces somo 00 00 somo 2 consutranion asoat 00 00 2s0a1 3. Puanwacy 070 00 00 ss078 (Gross AmountiOAR) ‘Advance Amount) Net Amount(QAR}: Relund Due In Words: (GAR)Zero | nereby undertake to settle any amount unpaid as a part of this invoice, Pationt signature: sull ofthe insurer’ sponsor deci 0 Cashier 10: