PSG HOSPITALS

Peelamedu , Coimbatore-641004
Phone : 0422 2570170 Fax : 0422 2594400

INPATIENT Bll: L - B! eakup 19-FEB-2018

Page 1 of 4
Patient Name: GAYATH RI. ~
IP Number: 11 8004711 DOA: 12-FEB-20 18
OP Number: 0 18009059
DOD : 19-FEB-2018
Bill No/Date: X 1800 1680 / 19-FEB-1 8 01ttGtNA.L

--- - - - ·- - - ---- - - -

Se rvice Amount
-- - - -
BED CHARGES
BED CHARG ES 12-FEB-1 8 120
BED CHARG ES 13-FEB-18 120
BED CHARGES 14-FEB-18 1,300
BED CHARGES 15-FEB-18 1,300
BED CHA RGES 16-FEB-18 1,300
BED CHARG ES 17-FEB-18 1,300
BED CHARGES 18-FEB-18 1,300
6,740
NURSING CHARGES
IDLNTIFICATIO N TAG CHA RG ES 12-FEB-18 50
NURSING CHA RGES 12-FEB-1 8 60
NURSING CHARGES 13-FEB-18 60
NURSIN G CHA RGES 14-FEB-18 300
NURSING CHARGES 15- FEB-18 300
NURSING CHARGES 16- FEB-1 8 300
NU RSI NG C HARGE S 17-FEB-18 300
NURSING CHAHGES 18-FEB-18 300
1,670
DOCTORS CHARGES
DOCTOR'S CHA RG ES 15-FEB-18 500
DOCTOR'S CHA RG ES 16-FEB-18 500
OGCTOR'S CHARG ES 17-FEB-1 8 500
DOCTOR'S CHARG ES 18-FEB-18 500
DR VISITI NG CHARG F:S -CRITICAL 12-FEB-18 810
CARE AREAS- LAE3OUR W Af~D / DAY
[ H~ VISITING CHARGES -C RIT ICAL 13-FE B-18 810
CARE AREAS- LABOUR W ARD/ DAY
DR VISITING CHARGES -CRITICAL 14-FEB-18 810
CARE AREAS- LABOUR WARD/ DAY
4,430
INJECTION & DRESSING CHARGES
DRESSING CHA RG ES (SMALL) 14-FEB-18 600
PR EPARATI ON/ENEMA CHARG ES 12-FEB-18 90
PR EPARATI ON/EN EMA C HA RGES 13-FEB-1 8 90
 PSG HOSPITALS
Peelamedu , Coimbatore-641004
Phone : 0422 2570170 Fax : 0422 2594400

INPATIENT BILL - Breakup 19-FEB-2018

Page 2 of 4
Patient Name: GAY/\T HRI.~
IP Number: 11 800471 1 DOA: 12-FEB-2018
OP Number: 0 18009059 19-FEB-2018
DOD:
Bill No/Date: X 1800 1680 / 19-FEB-18

Service Amount

INJECTION & DRESSING CHARGES

780
OPERATION THEATRE CHARGES
FC)R 1ST HALF A N HO UR 14-FEB-18 1,080
1,080
ANAESTHESIA CHARGES
LABOUR EPIDURAL A NA LGESIA 14-FEB-18 3,000
3,000
DELIVERY CHARGES
NORMAL DELIV ERY 14-FEB-18 5,400
5,400
C.P.LAB CHARGES
COMPLETE HEMOGRAM 12-FEB-18 300
300
MICROBIOLOGY LAB CHARGES
l'.NTI HCV A NTIBODIES 12-FEB-18 830
IH3SAG 12-FEB-18 500
HU MAN IMMUNO DEFICIENCY VIRUS 12-FEB-18 650
1/1! /\N f l BODI ES
1,980
BIO -CHEMISTRY LAB CHARGES
GLUCOSE RAN DOM (GLUCOSE STICl-17-FEB- 18 120
GLUCOSE RANDOM (GLUCOSE ST ICl<15-FEB- 18 240
GL'JCOSE RAN DOM (G LUCOSE STICl<16-FEB-18 240
GLUCOSE F{AN DOM (GLUCOSE STI Cl<14-FEB-18 360
GLUCOSE RAN DOM (GLUCOSE STICl<13-FEB-18 480
1,440
BLOOD INVESTIGATION CHARGES
BLOOD GROUPING 12-FEB-18 170
CROSS MATCHING & ANTIBODY 14-FEB-18 530
SCREENING
700
PHYSIOTHERAPY CHARGES
OBS & GYN rER STAY 14-FEB-18 510
510
 PSG HOSPITALS
Peelamedu, Coimbatore-641004
Phone : 0422 2570170 Fax : 0422 2594400

INPATIENT BILL - Breakup 19-FEB-2018

Page 3 of 4
Patient Name: GAYATHRI.~
IP Number: 118004711 DOA: 12-FEB-2018
OP Number: 018009059
DOD: 19-FEB-2018
Bill No/Date: X18001680 /19-FEB-18

ORIGINAL
Service Amount

DRUGS\SUTURE MATERIAL CHARGES

DISPOSABLE GLOVES 13-FEB-18 200
DISPOSABLE GLOV ES 14-FEB-18 650
DRUGS & SUTURE MATERIA L 13-FEB-18 68
DRUGS & SUTURE MATEf~IAL 14-FEB-18 592
1,510
SYRINGE PUMP CHARGES
SYRINGE PUMP 14-FEB-18 270
270
INTER DEPARTMENTAL OPINION CHARGES
ID CONSULTATION CHARGE ANAE 14-FEB-18 500
500
INFUSION PUMP CHARGES
INFUSION PUMP 13-FEB-18 270
IN FUSION PUMP 14-FEB- 18 270
540
INFUSION CHARGES
I.V LINE 13-FEB-18 60
60
DATEX MONITOR
SPECIAL MON ITOR 14-FEB-18 800
800
NST MONITOR
NST (FOETAL MONITOR) 12-FEB-18 300
NST (FOETAL MONITOR) 13-FEB-18 600
f\1ST (FOETAL MON ITOf{) 14-FEB-18 1,500
2,400 JI
ADMISSION CHARGES
ADMISSION CHARGES 14-FEB-18 550
550
HIGH RISK MONITORING
HIGH RISK MONI TORIN G 14-FEB-18 5,250
5,250
DIET :ouNSELING / SERVICE
 PSG HOSPITALS
Pee lamedu, Coimbatore-641004
Phone : 0422 2570170 Fax : 0422 2594400

INPATIENT BILL - Breakup 19-FEB-2018

Page 4 of 4
Patient Name: GAYATHRI ~
IP Number: 11 8004711 DOA: 12-FEB-201 8
OP Number: 0 18009059
DOD: 19-FEB-2018
Bill ~o/Date: X 1800 1680 /19-FEB-18
ORIGlWAL

Service Amount

DIET COUNSELING/ SERVIC E

DIET COUNSELING/ S[ RVIC E: 1?.-FEB- 18 50
DIET COUNSELI NG/ SERVICE 14-FEB-18 16 0
DIET COUNS[LI NG / S fN ICE 13-FEB- 18 233
DIE: T COUN SLLING / S ERVICE 19-FEB-18 348
DI ET COUNSELING/ S ERVIC 15-FEB-18 406
IJIET COUNSrLI NG / S l~ VIC 18-FEB-18 414
DIF·l COUNSCLIN G / S f: fN IC[ 16-FEl3 -18 512
IJll:T COUNSll ING/ S U { VICF 17-FEB 18 539
DI F ~I rl/\N If' VISIT MINOf~ 1?-FEl3-18 100
2,762
Net Amount: 42 ,672
 PSG Hospitals Diagnostic Center
Peelamedu, Coimbatore - 641 004.
Phone No. 0422-2570170, 2598822

INVESTIGATION REPORT

!Name GAYATHRI.S IP/OP No. 118004711

Sex FEMALE Age 29 yr(s) Adm. Date 12-FEB-18

CLINICAL PATHOLOGY

2-FEB-1 8 TOTAL RBC COUNT 3.71 x10"6/ul

HEMOG LOBIN 12.2 g/dl
HEMATOCRIT ( PCV) 37.0 %
• 2-FEB-" 8 MCV 99.8 fl
MCH 32.9 pg
MCHC 33.0 g/dl
ROW 12.9 %
TOTAL WBC COUNT 10.3 x10"3/ul
NEUTROPHIL % 74.3 %
LYMPHOCYTE % 18.5 %
12-FE B-; 8 MONOCYTE % 6.7 %
EOSINOPHIL % 0.2 %
BASOPHIL % 0.3%
ABSOLUTE NEUTROPHIL COUNT 7.7 X 10"3/ul
ABSOLUTE LYMPHOCYTE COUNT 1.9 x 10"3/ul
ABSOLUTE MONOCYTE COUNT 0.7 X 10"3/ul
ABSOLUTE EOSINOPHIL COUNT 0.0 x 10"3/ul
ABSOLUTE BASOPHIL COUNT 0.0 X 10"3/ul
12-FE B-18 PLATELET COUNT 232 x10"3/ul
MPV 7.9 fl
PCT 0.183 %
PDW 17.1 %

Authorised Signatory
We Care cl Cure with a Jfuman 'Touch
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 PSG Hospitals
Pcclamedu, Coimbatore - 641 004.
Phone No. 0422-2570170, 2598822

INVESTIGATION REPORT

Name GAYATHRI.S IP/OP No. 118004711

Sex FEMALE Age 29 Yrs Adm. Date 12-FEB-18

BLOOD_BANK
BLOOD BANK INVEST/GA TIONS
13-FEB-18 BLOOD GROUPING
GROUP 0
Rh POSITIVE
MICROBIOLOGY(SEROLOGY)
SEROLOGY
12-FEB- 18 HBsAg
RESULT NEGATIVE
Method Chemiluminescence
12-FEB- 18 HUMAN IMMUNODEFICIENCY VIRUS 1/11 ANTIBODIES
RESULT NEGATIVE
Method CHEMILUMINESCENCE
12-FE B- 18 ANT I HCV ANTIBODIES
RESU LT NEGATIVE
Method CHEMILUMINESCENCE

Authorised Signatory

We Care d Cure witli. a Jfuman 'Toucli.

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