Patient Name: Mr. Ramesh Kumar
Age / Gender: 45 / Male
Phone: +91 98765 43210
Address: 12, Anna Nagar, 2nd Street,
Madurai - 625020, Tamil Nadu
Madurai - 625020, Tamil Nadu
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VASANTHA
C L I N I C
Compassionate Care, Better Health
BILL TO
INVOICE FROM
Vasantha Clinic
No. 45, Health Care Street,
Arappalayam, Madurai - 625016,
Tamil Nadu, India.
Arappalayam, Madurai - 625016,
Tamil Nadu, India.
+91 91500 12345
info@vasanthaclinic.com
| # | DESCRIPTION | CONSULTATION / TESTS | QTY. | RATE (₹) | AMOUNT (₹) |
|---|---|---|---|---|---|
| 01 | Consultation Fee | General Physician Consultation | 1 | 300.00 | 300.00 |
| 02 | Complete Blood Count (CBC) | Laboratory Test | 1 | 450.00 | 450.00 |
| 03 | Blood Sugar (Fasting) | Laboratory Test | 1 | 150.00 | 150.00 |
| 04 | Urine Routine Test | Laboratory Test | 1 | 120.00 | 120.00 |
| 05 | X-Ray Chest (PA View) | Radiology | 1 | 400.00 | 400.00 |
| 06 | Medicine & Treatment | Prescribed Medicines | 1 | 580.00 | 580.00 |
PAYMENT INFORMATION
Payment Mode: Cash / UPI / Card
Transaction ID: —
Payment Date: 28 July 2025
Subtotal₹ 2,000.00
Discount₹ 0.00
Taxable Amount₹ 2,000.00
CGST (2.5%)₹ 50.00
SGST (2.5%)₹ 50.00
TOTAL AMOUNT₹ 2,100.00
Amount in Words: Two Thousand One Hundred Rupees Only
IMPORTANT NOTE
Please keep this invoice for future reference.
Payment is due within 7 days from the invoice date.
Thank you for choosing Vasantha Clinic.
Payment is due within 7 days from the invoice date.
Thank you for choosing Vasantha Clinic.
✦ Thank You! ✦
We wish you good health and a speedy recovery.
Ram Sasoin
Authorized Signature