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This tax invoice is for a medical visit by patient Kirthika Ganeshan on January 27, 2025, with Dr. Aswathy Mechur Jayachandran in General Medicine. The total amount payable by the patient is AED 21.60, with a payer balance due of AED 86.40. The invoice includes details of services rendered, payment methods, and contact information for Aster Clinic in Dubai.

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kirthika356
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13 views

get

This tax invoice is for a medical visit by patient Kirthika Ganeshan on January 27, 2025, with Dr. Aswathy Mechur Jayachandran in General Medicine. The total amount payable by the patient is AED 21.60, with a payer balance due of AED 86.40. The invoice includes details of services rendered, payment methods, and contact information for Aster Clinic in Dubai.

Uploaded by

kirthika356
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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TAX INVOICE

TRN No: 100255946400003

Patient Name : Kirthika Ganeshan MPI Number : 1003428148


Encounter No : DMAQMC/24-25/ENC-74919 Visit Date : 27-01-2025
Receipt No : DMAQMC/24-25/ORD/RC-63906 Receipt Date : 27-01-2025
Doctor/Dept : Dr. Aswathy Mechur Jayachandran Specialization : GENERAL MEDICINE

MPI # :

Description Qty

GENERAL PRACTITIONER - INITIAL VISIT 1

BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC COUNT 1

RADEX SINUSES PARANASAL < 3 VIEWS 1

Deductible 5.00
Copay 16.60
Adm Charge 0.00
Selfpay 0.00
Tax Amount 0.00
Patient Payable 21.60
Payer Payable 86.40
Current Paid Amount 21.60
Payer Balance Due : 86.40 Patient Balance Due 0.00
Total Current Receipt Amount : AED Twenty One And Sixty Fils only
Current Payment Details

By Advance : 5.00 Card : 16.60

Tokens
* Token# WS-AM-047
1 Lab Common Waiting Area-First Floor-Room No:010
2 Radiology Common Waiting Area-First Floor-Room No:7

Printed Date & Tme : 27-01-2025 22:01 Sajan Saji Yohannan


(Cashier Name)
----------------------------------------------------------------------------------------------------------------------------------------------------
Aster Clinic - Al Quoz
Al Quoz Industrial Area 1,
Near Old Grand Mall
P.O Box:8703,Dubai, U.A.E.
T +971 42425645 | +97144400500
E-mail: [email protected]
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