IPF Patient Information

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Patient Details
Patient Name
Sex
Age
IPD No
OPD No
IPD Date
Discharge Date
IPD Department
Transfer Department
SrNo Receipt_No Receipt_Date Department Sub Test Test Charges Paid Amt
Ration Card Type
-
Total Amount Paid
IPF Receipt
IPF Start Date
IPF Receipt No
IPF Receipt Date
Department
Diagnosis
Test Name
Charges
Patient Paid
IPF Amount
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SrNo R_NO R_Date R_Department TestName Charges Patient_Paid IPF R/A
Total Charges
Patient Paid
IPF Amount

Godavari Foundation's
Dr.Ulhas Patil Medical College And Hospital
Jalgaon Kh.Jalgaon-Bhusawal Highway Tal.Dist.Jalgaon-425309
RECEIPT
Receipt No. Date :
Patient Name :
Male. : Age. :
OPD No. : IPD No. :
IPD Date. : Discharge Date: 
Department : Ration card: :
Diagnosis :
PARTICULARS CHARGES PATIENT PAID IPF AMOUNT




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