Patient Invoice

UHID: UHID/25/1001
Date: 06-Sep-2025
Name: Sumit Kumar
Age/Sex: 31 Yrs/Male
Mobile: 8398236458
Address: Lucknow UP
Vitals
Temp SDFDFGSDG RBS SDFG BP SDFG
SpOâ‚‚ 45 RR DFG Pulse SSDFAS
Height 5'7 Weight 65 KG.
Clinical Information
Symptoms: MBSDKJGRTYERTY
General Examinations: WOEYFHOHQBASKDFB
Investigation Advised: ASDFASDFASDF
Test Name: SSNDFLNASD FASNDFASDF AS NDFLAS FSNKAASOIFHQ M,XCV F MV
Treatment Details
Treatment Type: Root Canal Treatment
Issues In Teeth: Tooth5,Tooth6,Tooth25,Tooth24
Claimed Insurance
Insurance Company: LIC Health
Policy Number: ABC123456789
Claim Amount: 1500.00
Relation to Policy Holder: Self
Prescription
# Medicine Frequency Duration Instruction
1 Paracetamol 200mg 1-1-1 5 Days khane ke baad
2 Dolo 300mg 0-0-1 5 Days Night me khane ke 2 ghante ke baad
3 Antibiotic 200mg - - -
Billing Details

Amount in Words:

Five Thousand
  • Treatment Charges ₹ 5000.00
  • Discount - ₹ 500.00
  • Received Amount ₹ 3000.00
  • Remaining Amount ₹ 1500.00

Diet Plan: ASNKNASKLF KAS DKLANS DFNASFLAS DFS

Revisit Date: 30-Aug-2025

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Authorized Sign