— 4 Balaji Hospital Above HDFC Bank, Ambedkar Road, Karimnagat. Ph : 9247 422727, 9550 422727 EMERGENCY CERTIFICATE Date: This is to certify that Ms/Mrs. : K.LAXMI Age: 58YRS Gender : FEMALE Husband's / Father's Name —: K,DURGAIAH IP NO :.3428/2022 Has taken treatment in this Hospital as In-patient from DOA : 08-11-2022 DOD: 11-11-2022 Suffered from: BILATERAL PNEUMONITIS / TYPE2DM/HTN In an emergency condition under from DR.K.VENKATESHWAR RAO M.D (CONSULTANT PHYSICIAN) THIS IS TO CERTIFY THAT MRS.K. KARIMNAGAR ON 08-11-2022 TREATED FOR BILATE CONTACT FOR QUERIES. Au BALAJL i. K. Venke Consultant p} shy Regd. No: 8asig Me) 41-11-2022 “LAXMI ADMITTED AS AN EMERGENCY AT BALAJI HOSPITAL, AMBEDKAR ROAD, ERAL PNUMONITITIS / TYPE 2 DM / HTN I1-11-2022. PLEASE ‘Signature HOSpry, ateshvar Roo & scanned with OKEN ScannerE SSENTIALITY CERTIFICATE This is to certify that Mr./Mrs.:K Laxnm Husband's / Father's Names: K.DURGAIAH IP NO 1 3428/2022 From: 08-11-2022 To: 11-11-2022 Treatment : BILATERAL PNEUMONITIS / TYPE 2 DM/HTN And below investigations / Procedures / Medicines Prescribed by me inthis connection were essential for recovery / Prevention of serious deterioration of the conaltion of the patient. The medicines are not stocked in the hospital for supply to Patients ang do not include proprietary preparations for which cheaper substances of equal therapeutic value are avaliable or Preparations which are primarily foods, toltres or disinfectants, Towards Paid Amt Hospital & Consultant Bills 2000.00 Investigations & Bills 4650.00 Pharmacy Sales 11061.90 Total: 35711.90 Aut! BALAJI HOSPITAL Dr. K. Venkateshwar Rao Consultant Physician" Regd. No: 88310 ef) & scanned with OKEN ScannerBalaji Hospital ove HDFC Bank, Ambedkar Road, Karimnagar. Ph : 9247 422727, 9550 422727 Patient Payment Details comer Totalamt Discame Netamt. Paldamt __DucAmt Patient Name: KANAKAM LAXMI Regbate : 08/11/2022 15:17:27 MRNO : MR11202236422 IPNO__: 1P3428 IP COLLECTION 2000.00 0.00 2000.00 2000.00 0.00 LAB COLLECTION 4650.00 0.00 4650.00 4650.00 0.00 Pharmacy Sales 12748.46 0.00 12832.48 12832.48, 0.00 Pharmacy Sales Returns -1770.58 0.00 -1770.58 -1770.58 0.00 Grand Total : 35627.88 0,00 _-35711.90 __-35711.90 0.00 & scanned with OKEN Scanner1D Print Date: 2001/2022 patient name Mrs. KANAKAM LAXMI A a ge 1400 1P3428 sno__Regno Reg Date & time Invst Name TotalAmt _Disc___—Paid__—_—Due 08/11/2022 1 47807 08/11/2022 12:01:20 RANDOM BLOOD sucaR 100.00 0.00 100.00 = 2 47807 08/11/2022 12:01:29 COMPLETE BLOOD PICTURE (C8) 25000 000 250.00 0.00 347807 oar1/2022 12:01:20 ECG. 20000 0.00 © 200.00 oy 4 47807 (08/11/2022 12:01:20 SERUM CREATININE 200.00 0.00 200.00 ea 5 en osrvaoze tases ZDEoNG Co i Day Total: 2250.00 0.00 2250.00 09/11/2022 500.00 2.00 8 aet6 Onta0z2 082043 SERUM ELECTROLYTES ee oe 7 47816 08/11/2022 08:20:43 SERUM CREATININE. ao on enol 0.00 8 47816 0811172022 08:20:43 CRP (C-REACTIVE PROTEIN) co ca a 0.00 8 47816 0811112022 08:20:43 COMPLETE BLOOD PICTURE (CBP) cal oa em | | O80 Day Total : oe oo 14/14/2022 25000 0.90 250.00 °. 10 | 47869 ‘1111/2022 08:06:41 COMPLETE BLOOD PICTURE (CBP) a 0.00 1 47869 11/11/2022 08:06:41 GRP (C-REACTIVE PROTEIN ) fp Day Total : i 4650.00 0.00 Grand Total: 4650.00 0.00 BALAJI HOSPITAL Dr. K. Venkateshwar Rao Consultant Physician MO(P)) Regd. Ni 38310 & scanned with OKEN ScannerPatient Medicines Details Sf medicine Batchno ExpDate” Biba = Patient Name: Mrs. KANAKAM LAXMI Ino Qty PaidAmt _Dueamt OPNO + OP0811202233027 MRNO 2 MR11202236422 IPNO + 173428 09/11/2022 Sales vows i 3729 s1o7r02s srtveo22 132326 © pHET200 «2 1600 0.00 F2202614 — 31roaz02s oanireo22 132328 © PHET20O 14 102 0.00 PANTINIV PNOATTIA — sivoere024 osrt2022 132326 © PHeT290 4 21800 0.00 ETERNA AMP 24. 2A822206 —so)os2024 og/r12022 132028 PHET200 mas 0.00 CEGAVA 1.56 IN BAR1137 9107/2023 opntr20z2 13:23:25 PHB7200 «4160446 0.00 LASDKING att, 222098 30/0672028 og/ivz022 13:2826 PHET200 «2 2456 0.00 HUMAN ACTRAPID 40 7069s s1/oerz024 oa/2022 132326 PHET20 1 15842 0.00 MILITIAANE 2ML AMPLE BE2208-85 3101/2024 oattm20z2 132326 PHET20 3 351.00 0.00 PULMOFINE NAC TAB SGUD548 — s1/1072023 ont/2022 132326 PHET280 © 10 288.00 0.00 INSULIN IML SYRINGE taa7eea 317272026 oertt2022 132328 © PHET290 2 1880 0.00 OXY SET MASK (A) 22084050 st07/2027 op/ire0z2 132528 PHET200 © 1 230.00 0.00 FOLEYSCATH(RUSCH) 126 21102525 sort1/2025 owttr2022 13.2828 PHT200 «1 180.00 0.00 UROMETER (RAMSONS} 15965 1os2026 op/szcze 132528 © PHET290 tt 572.00 0.00 LOX. 2% JELLY Losa7 311082024 oait12022 132328 © PHET200 39.30 0.00 WATER AMP zazeads 310872025 0011172022 132328 © PHET2000 1 288 0.00 SURGICAL GLOVES 7.5 2263010 310372028 og/ttro22 132328 © PHT200 1 80.00 0.00 BUDAMATE NEB 0.5MG 2iRI0s §——-31/0572028 ogrtt2022 132326 PHETZD 4 21260 0.00 [AERONEB MASK (ADULT) 2a0s4nse8 — 30/042026 osIt1/2022 13:2828 PHET;0 1 608.00 0.00 IVCANNULA 206 220610746 31/08/2027 os/t1/2022 1323268 © PHE7200t 178.00 0.00 EASYFIX (M) EFME05.0822 31/08/2025 os/t1/2022 13:23:26 © PHE7200 1 4500 0.00 VEIN-O-LINE 100h 21082263 31/07/2028 on/IN2022 132326 PHe720 «1 347.00 0.00 IV SET (ROMSONS) 220820612 31/08/2027 oB/t2022 132328 © PHeTZ0 «2 352.00 0.00 NS 500 ML STERIPORT 160620577" 20/06/2025 08/1172022113:28'26 PHe7200 4 49.76 0.00 EXAMINATION GLOVES MEDIUM 112021986 31/01/2027 os/11/2022 132326 PHeT200 «6 42.00 0.00 0G LeeDs 2sosco —-sov04/2024 o8/ttz0z2 13:20:28 PHET200 138.00 0.00 'NS 100M STERIPORT sosz021s 9/08/2025 oerr¥2022 13:25:28 PHET290 «2 188,04 0.00 Ns 100ML STERIPORT sosz021s 3170572025 o8/1172022 132526 PHET2G0 4 168.04 000 wee x28 snros02s oa/2022 13:25:26 © PHer290 «8 96.00 00 & scanned with OKEN Scannerre tien “get Batchno _ExpDato Bilbate oT Patient Name Mrs. KANAKAM LAXMI no __ Gly _PalArt Overt oPpNo + 0P0811202233027 MRNO + MR11202236422 IPNO : 1P3428 oe at fete sea canto. 181640 pHerI02 © mao 2027 oantaoze iete40 | PHETI02 1 a30 (000 {Ns 100M. STERIPORT 50620215 31/05/2005 orrv2022 18.1640 PHETSOZ 1 ao 000 609892 0.00 4011412022 Sales MIUTIANE 24 AMPLE Bez20e|s — s1/ov0et taraaoze tons? © PHeTSeD 2 7800 on UASOK NY ab 2i2a0s9 © somerzoas tarwanze 110387 PHET320 1 1228 000 EETERNA AMP 24 zaszzz04 —ovoazo2s torimoze 110387 PHOTS20 7 100.3 o.co aT NEEDLE zzoscormt —voe27 tarimoze tv0as7 —PHETSIO 330 oo NS 100M STERIPORT sosacars sinsrozs orizoz2 1103s? PHETSIO + 18.08 00 CGABAPIN NT 100 wonoases soroze toriraoza 1i03s7 PHETE@ 5035 0.00 DYNAPAR AQ INS 1ML posssen — sitzrgs sonia vias? © PHETED so6 00 INS 600 ML STERIPORT soozosry 002025 1011172002 110887 PHETS2O 1 eras 0.00 PANTIN pNDATTiA sioaraze torii2oze wross7 —PHETSD 2 10900 00 CEGAVA 156 INS eaziior — 30ormzs san1me022 110887 PHBTIQ0 2 e222 000 NORADINS geraas ——swrosnoze torv2en2 vt0xs7 —PHETS20 2 12620 0.00 PM OLINE 160M zonei1i23 3isroa7 ive 110387 © PHOTS0 1 349.00 000 soce poormost —soosmo2? tonnzoze tons? PHOTO 50.00 0.00 yaunavon cLoves eon — sizziass voter sorta 14087 | TEMS 4200 0.00 occ xaos 90092025 102022 110887 PHETIQD 2 2400 000 acc sr28 suormas vorvvm022 1150087 © PHETS20 2 1800 0.00 ETERNA AMP 2 zanrao, —s)od2024 10/11/2022 1715853 PHETMS 2 2058 00 aco ar aivoranes tirvoz2 19:91:30 PHBTS5S 1600 000 LevOFLOKW aazoois —«S4t2R024 012022 193190 PHETSES 207883 000 DDYNAPAR AQ INS HL pzsssee — ovt2023 o/vva0z2 19190 PHOTSES 2 e692 0.00 LASiXINy at 2izz069 «3006/2005 trt12022 19:31:30 PHETSSS 1 1226 0.00 [ETERNA AMP 2ML ‘zABz2204 30/04/2024 10/11/2022 19:31:30 PH67355 2 28.58 0.00 BT NEEDLE zzoanorT — sv0erzo2T sorivanz2 193130 PHETSES 3 990 0.00 aAZti37 | 3¥0772029 0/2022 199190 PHETSSS 1 aout 0.00 CEGAVA 1.56 INJ & scanned with OKEN Scanner‘Full Addrer cont 2 ca Batchno _ ExpDate BilDate Zoent wae? Mrs. KANAKAM LAXMI Billno Qty PaidAmt —_DueAmt ‘opNo + OP0811202233027 MRNO- + MR11202236422 IPNO : [P3428 vib 2M eae ee ee Ait ei tontvz022 19:31:30 PHETI55 1 sat 0.00 aaa Sect 27 sorviz022 19:91:90 © PHOS 8 am oo a aa 12024 soiizez2 19:31;90 PHOTOS 5450 0.00 01S surs2z024 soninzoze 194631 PHETIS2 207.63 000 3705.61 0.00 1111112022 Sales AGONYX-MR TAB AXR-2201 ‘s1osv20z4 11/11/2022 11:19:03 PH67366 5 94.50 0.00 ZIFFINAG GEL F208 ‘wvosreozs 11/2022 111903 PHETI06 = 410.00 200 (CEGAVA 1.5G INS BA21137, ‘guvo72023 14/11/2022 11:19:03 PH67366. 1 401.01 0.00 PANTIN IV PNDAT71A 31/08/2024 11/11/2022 11:19:03 ‘PHE7366, 1 54.50 0.00 ETERNA AMP 2ML zaszones — silormoes sw/ivaaze 11-1903 PHBIEG 1420 0.00 BT NEEDLE zaomarn — swvosnoz t1nsraqze 111909 PHETIES 6.60 0.00 soo Rxa2a sonero0as tnizoe 111903 PHETISS 36.00 0.00 DYNAPAR AQ INJ #ML passsec 31si2m0zs tinsmeoze 11-1903 PHBTIGB 33.46 0.00 IV CANNULA 206 aposroras — 1mosmozT 11/2022 125024 PHETST! 17600 0.00 EASYFIX (M) ermeos.oe22 31sn02s 111202 125324 PHOS! = 45.00 0.00 PULMOFINE NAC TAB ssouosis s1/i0z023 1/2022 16-1410 PHETSEZ 18 452.00 0.00 INSULIN IML SYRINGE joarass —30riz026 s1/iranee se.14:10 PHETSEZ 3 2820 0.00 METSMALL 5006 eooonera — 300sre0as 1/4/2022 16:14:10 PHBTE2 28 54.08 0.00 P-PANOSR CAP ee 97:90 0.00 CGLEVO 500M TAB pwoapor s1loerzo23 1112022 16:14:10 PHO73E2 7 63.35 0.00 POZOCEF CV 200 TAB ‘ros00ss0 © ovograo23. 11/11/2022 16:14:10 PHETIB2 195.00 0.00 POZOCEF CV 200 TAB rezoosso — somps203. 11/11/2022 16.1410 PHETE2 = 10 390.00 0.00 Sales Returns BUDAMATE NEB OSG pants 3170072028 11/11/2022 16:11:55 6164 3 159.45 0.00 NS 600 ML STERIPORT sosv0s77? 301062025 11/11/2022 16:11:55 6164 1 8744 0.00 Ns 100M STERIPORT 5020215 stosr202s 11/11/2022 16:11:55 tee 1 #201 0.00 eT NEEDLE zaomorn — swgsao27 111172022 16:11:85 6164 7 2310 0.00 30c ar 1107/2026 11/41/2022 16:11:55 6184 1 8.00 0.00 & scanned with OKEN Scannerici il pedicin® Batchno ExpDate BillDate Bilino auient Name Mrs, KANAKAM LAXMI — oPNO + OP0811202233027 MRNO- + MR11202236422 IPNO : 1P3428 PANTINIV PNOATTIA ot yore rivaoze vetiss ted 5 PMOLINE 15004 220611123 31/05/2027 11/11/2022 16:11:55 6184 . $343.00 0.00, bocce 220720816 © — 30/06/2027 11/11/2022 16:11:65 6184 . -60,00 0.00 NORAD INI arate arosrozenrtv2022 18:4185 tes Aor a 2122038, 31/01/2025 11/11/2022 16:11:55 6184 1 514 0.00 ETERNA AMP 24 zaezzz04 —sooanoas ttvnze tens 84 + az 000 DDYNAPAR AG IN IML esssee —sytacs tanga vernss 6104 er Lasix Ns a, zimoee —stoenas tine 1s88 te 1 122 000 LASIKINS AML raaoie sores tirnna yexnss 6104 1 a8 CEGAVA 156 NI enatisr — svoragzs syivanze weanss 6104 + aot 000 Oxy SET MASK A) zacesosos soviet 11n4a020 16188 184 7 om om GGABAPINNT 100 zzoanes —svorrnae ‘112072 vex0s 688 5 om 46137 0.00 Grand Total: 11061.90 0,00 BAKAJI HOSPITAL Dr. K. Venkateshwar Rao Consultant Physician MOM") Regd. N & scanned with OKEN Scanner