® UNIT HASIL, SEKSYEN PENGEBILAN CAWANGAN KEWANGAN HOSPITAL KUALA LUMPUR TEL: 03-26455555 Samb, 6607/5088 JALAN PAHANG FAX : 03-26155053 ‘50586 KUALA LUMPUR WEBSITE: wwwe.hkl.gov.my HOSPITAL BILL PATIENT NAME ZAHIDA PARVEEN. DATE ADMIT 15/11/2016 VICNO. / PASSPORT NO. :AS3996062 DATE DISCHARGE ADDRESS 1 A-293 SETIASKY REGISTRATION NO KG BHARU BILL DATE 50300 KUALA LUMPUR BILL NO. DESCRIPTION ‘AMOUNT (RM) CHARGED: WARD- 3" CLASS RM 160 X 11 DAY(S) 1760.00 INPATIENT TREATMENT RM 10013 DAY(S) 3100.00 INVESTIGATION US SWAB CULTURE & SENSITIVITI Mao x3 120.00 LucosTix RM62 X2 62.00 CULTURE OF CLINICAL SPECIMEN MAO X3 120.00 LIVER FUNCTION TEST M100 X2 100.00 MAGNESIUM RMS x1 15.00 PHOSPHATE M20 X1 20.00 RENAL PROFILE RMBO x4 320.00 PROTHROMBINE TIME (PT) M30 x1 30.00 FULL BLOOD COUNT MAO X3 120.00 catcium aw20 X41 20.00 (GROUP SCREEN & HOLD (GSH) RMG8 x1 62,00 "TOTAL CHARGE FOR INVESTIGATICi : 995.00 PAIN VISUAL ANALOG SCALE aM 40x12 40.00 BURN - PRIMARY TREATMENT RM 2508 X1 2508.00 ACTIVE, PASSIVE, RESISTED RM 80X10, 300.00 NUTRITION ASSESMENT RM 70X3 210.00 ENTERAL NUTRITION FORMULA RM 70X7 490.00 TOTAL CHARGE FOR TREATMENT 4048.00 TOTAL CHARGED 03.00 >A ] \ > _() DEPOSIT 7200.00 oumenls— TOTALTO BE PAID 6703.00 ce ++ payment can be made by cash, postal order, money order or bank draft Payment can be made at the HKL In-Patient Registration Counter (24 hours) @ Thank you ‘THIS LETTER iS COMPUTER GENERATED SIGNATURE IS NOT NECESSARY