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PROCEEDINGS OF THE

O'RECTOR OF
p rese
nt: D r
,. R a m e s _i:?]T ::,#:l:i::;liilti ili;
Director ^of Medical Education
HyD ERA BA D

Procdgs. No. ZB23O/ p


L/2OLB
Dated 02.11.201.8
Sub: DrilE' T's'' Hyd' - TrMA Rules,
7972 - Renerryar of Recognit
M/s Apo',o Frospitais, Aporio Healtlr ion of r,/r/s
Hyderabad
city campus, Jubiree Hiirs,
- 500096 as Refe,rra! Hospital for the purpose
of treatment
ro state Governn'ient Enipro'7ees
both in-service & Retired and
their
|ll:nr9ntt' Yu\'ttr!tc's, Ex. t/tLA,s/MLc,s and other categories of
personsBS per TIMA Rules,
Ref
lgl2 - Sanction Orders _ lssued.
:
1. G,o. Ms. No. to2 Httl&F\tt
{r<r1 ofr,; ;tatea. B_0s_2005.
2. G.O. Ms. No. 4/7 Htut&Fw (K1i
'r'hi.s Deptt. Oat"a. SO_OS_ZOOS
3. ot'iice Rc.rrJo.2lz3oip1/2orA
ii.-ri.iO.18 to the Superintendent,
Osmania General Hospit;l, Hyrlerabad.
4, lnspeciion Report No.peshi/OG
Hlzlrc/n36 dated 29.10.201g of the
Superin tende nt, Osma n ia
General Horpiiaf , Hyderabad.
(f)>
OfTDEIi:
ln exercise of the pov/ers delegated
in the references cited, the
Education, Terangana state, oirectorof.Medical
Hyderabad is preased ,, ..."r0
M/s Aporo Hospitals, Aporo n.rJ*, renewar of r.ecogniti on to
M/.s
city campur, ,rlir"" lrirs, Hyderabai _
Rei'erral Hbspital to the 500096 as
categories of parro* as mentioned
in the subject, for treitment on
in respect of the foiloutins ro..,ri,i,.r,rnaesrhesi
:il,:[T:;:, jrr,, otosy, cardiotw,
Nephrorogy,*",['rT]r..TI;,:,Hff
Surgerv, purmonorogv, Radiorogy
Physiotherapv unit and oiarysis
Il,ry;Tr";r:m**,"ru;:il:,ffi
surgicar Gar;;;;;!y,.surgicat
Jnii ,n0., ,rr. roilon ing lo-ri,,,or, (as oncorogy, tJrorogy,
f
out & in patients)
L Tlre Hospital should give free treaiment
to white cardholders
. or Berow poverty Line (BpL)
to a minimu m 5% of bed strength (for
inpatien, ,.J.uri
2. The Hospital should give free medical
treatrnent to Students of SC.
schools' sr' Ashrarna schools,
s.r. Hostels, G.v.v.K. t.t,."; and / ST / gCResidential
3' The Hospirar author:ities rr',"rlJ airplav about;"'iJl'tment Maabadi schools.
in Hospitar
The Hospital should provide
0",,"i ,"i,cal and hearth ,iirla", incruding premises.
conducting Health camps, once Diagnostic
in , ,;;,;; which are menrion,edservices,
[4.O'u cheve[a, nangariddv Dist., *fii ;il in the
and,Nauigudem ;ilrr; Nargonda
renewal' the list of camps Dist. Ar the time of
to"ari *ith cam; 4.t", & rist of persons attended
fi'rr lhp ramp,rrong with "o numbers,
their. ronract "r"lname
1' The Frospitar .shourd submit mcnthiy return have to be submitted,
5. The Hospitat ccncerne.rJ should in the prescribecr tormat.
ctraige_for att raedi,caiiirrr,.r,
by thern under this scheme,
es per liu pr.trge ,r,.r'or.riribed
/ Diagnostic5ervices given
Ilinistrv of Health and familv vr/elfare by Governmeni of rndia,
for c.e.i,s., iiaZrriraand
Governarent in G.o. rvrs. rrro.
,o, rniarw {r.r1 osra[;;;; Datedas adopted by the state
be presci'ibed by the state Governr.r, 15_03 -2005 or as may
or the Direct o, of iteaical
tirne. T,s: Drrectr.:r r.:f lleclic;l Education from time to
Education
that the charses tevied by ,h. ,rirr,. .i Scritiinizing airthority shall verii,y and ensure
certilrying thc' net admissible
;;;r;;;: ,;,;", the above rates, before
arnount. lf the rates or prirrt.
c'G'H's' package rates Government Hospitals are less than the
rares of private Hospitals
/ rates as o;, ;r;;-; to the said G.o. the rowest
sha, be acc.epted fo, sirrtiif
anJp-r,r.nr.
:' :l:J:'i::1"',""::TH:;*li:,fv i
the rates ;;:;,;;,,evied bv Hospita,
at the
7
shourd Rs' ii,iiii'ti'rpees
pav
l*X;:::'l rhirtv Thousand onty) towards
rnspe*ion ree

Contd. on page:Z
:12:i

8. All other Guidelines mentioned in the references should be follov.recj scrupulously.


9. Medical Bills entitled as EHS/Company paymenis are noi reimbur'sable.
10. The permission accorded to the Hospital is liable fr:r canceliatiorr anc.i such orher r?ctiorl as
deemed fit, including de-recognition of the Hospital and initiate crirniiial ".rcticr as per l;iw
against the Hospital, whenever the State Gcvt. forms the opinion based on inspection or'
enquiry into the allegations that the said Private Hospital is noi providi!'jg treatnterlt to ihB
State Government Employees / Retired Employees and their Dependents etc., as
stipulated above and violates the conditicns mentioned therein, and incJuige any
irregularities in respect of excess/bogus claims, cheating the patieni or Governmettt ot'
resorting to any unlawful activities eic., after giving fifteen {15i days nr:tice to ihe Hcspital
artd p.rss.:ppropriate crders, after considerirr6 iir,'reDr€s{.lrrtatiui:..i irrri', oifi':lii i..r.i il'r'
:aid Hn:pital
11. These orders are va-lid from22,Q7,2018 to 2L,07.2027.
12.. An scrutinizing offlcers should follow these guidelines in admitting the bills.
Sd/- Dr. K. Ramesh Reddy
' ./' Dirpcto( of Medical Fdtrcation
/ / ateste dl/

To
The Managing Directori M/,s:Apollo Hospitals, Apollo Health City Carnpus, Jubilee Hills,
Hyderabad - 500096
Phone:040-60601oeelizaOlll7 E.rnail- apollohealthcity@apollohospitals.com
All the Heads of DepaftmentsT Govt of T5, Hyd.
Th.e Pay and Accounts Officer,. Hyd.
All the District Treasury Officers in the State
Copy to the stock file.

.:,'. :

ttF[,
$f Apollo Health city campus, Jubilee Hills, Hyderabad - 500 096.
ffi *gt-1860 258 1066
ft apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffi apollohealthcity ffiapoltoheatthhyd H@ apoiloheatthcityhyd D;
A0bllo
THOSPITALS

RTIFICATE
CEBTIFtCATE-B
Certificate granted to Mrs . f lt1r. f Miss. MoHD IDRIs , Wife / son / daughter of

Mr. / l[rs, / Miss. @EED ALI Address in. ANGANA INDIA.


PART - A

l, Dr. _-
here by certify
(a) That the patient was admitted
to hospital on my advise
(b) That the patient has been under
treatment at Apollo Health city,Jubilee Hills,
Hyderabad and that the
under mentioned medicines prescribed by me in
this connection were essential for the recovery/prevention
of serious deterioration in the condition
of the patient. The medicines are not stocked
in the
Apollo Health city, Jubilee Hills,Hyderabad
for supply to private patients and don not
include
proprietary preparations for which
cheaper substances of equar therapeutic
value are available not.
preparations which are prirnarily foods,
toilets or disinfectants
S. No Bill Date Billl Receipt No Service Provided at Amount incurred

1 04-09-2019 JBH-OCS-1935905 APOLLO HOSPITAL


850.00

2 0s-09-2018 PET-O CS-22965


22,000.00

3 14-09-2018 JBH-tcs- L2A027 APOLLO HOSPITAL L,90,000.00

TOTAL BILL 2,L2,950.00


BILL AMOUNT tN WORDS : Ru ees Two lakhs twelve thousand

( c ) That the iniections administered


were/were not for immunizing of prophylactic purposes

(d)Thatthatpatientis/wassufferingfrom@LMUcosA.

MUCOSA

_and is /was under treatment from

Contd.2

Regd' Office : Apollo Hospitals Enterprise Limited, No. '19, Bishop Garden, Raja Annamalaipuram,
Chennai - 600 o2g, Teli +9144-2g293333, Fax: +91-44-2g290956
Corporate tdentity Number (CtN) : LBS11OTN1979PLCOO803S

"KEEP THE REPoRTS CAREFULLyAND BRING THEM ALoNG oururo voun rExr vrsrr ro oun xospral.l
Sl Apollo Health City campus, Jubilee Hilts, Hyderabad - S00 096.
fl *gr-1860 258 1066
ffi apollohealthcity@apollohospitals.com @www.apollohealthcity.com
$ apollohealthcity ffiflapoiloheatthhyd r@ apofioheatthcityhyd

.'lT,::
"' yiil:."",.:Tjl
' : ffi Hiff,T lffi ill ro r t rea t m e nt an e we re u n d e rta ke n o n my

(f ) that I called on Dr.


{onsultation and that the necessary
rules was obtained.
approval of the Medicar superintendent
For specia tist / referra I
as required under the

signature and designatio


Wrr officer
Date: 1.2/AI/ZAL} ln-charge of the case atlthe
Hospital

DT. ARSHEED HUSSAIN HAKEEM

con su ta nt s u rg,:lt_qrpbs
I

Regd.No. AP Nl C/Ft,f RIBB5 3B


fl:,flrl [:]fr
PART-B Apollo Hospitals,
'lubilee Hills, Hyderabad_g6.
certify
that the patient has been
under treatment at the Apollo
and that the services of Hearth city,Jubilee Hi,s,Hyderabad
the specia, which an expenAiture of
"*r"Jr. Rs. ........, Was incurred,
vide
,TI;iilffi llT|.il[|r*u,.u """'i'''i", rn" recoverv / ,,."r*,,on orserious deterioration in

signature and designation


of the
Date: 1.2/01/2019 ln-charge of the case at
the Hospital ^rffiK,
DT. ARSHEED HUSSAIN HAKEETVI
MS{ENT), FHNS ,

Consultant Srirgical oncology (Head & Neck)


Regd. t{0. AP [\jl C/F M Ri BB 53 B
COUNTERSIGNED Apollo Hcspitals, Jubilee Hills, Hyderabad-96.

I certify that the patient


has been undertreatment at the Apo[o Hearth
and that the facilities provided city,Jubilee Hilrs,Hyderabad
were the minimum which
were essentiar for the patient treatment.

Date: 1,2/01,/2}lg

I uuuSPfiiii: : ilGabad.eo'
Regd' offlce : Apo'o Hospitars Enterprise Limited,
No. 19, Bistop Raja Annam"lg,p*31_cl:.nnai - 600
-carden,
corporate ldentltv Number (clN) : L85110TN1szspt_coogoii
---' Ter:+g,144_29293333, Fax +91.44-28290956
028,
$f Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
g +91-1860 258 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffi apollohealthcity ffiapollohealthhyd a|@ apollohealthcityhyd
Dt
Organizatbn Acq€dit€d
by Joint Commiseion lntematonal
ASbllo
luosPrrALs

EmerEencv Ad missign cegificate

This is to certify that Mrs. / Mr. / Miss . MOHD IDRIS , Wife / son I daughter of

Mr. / Mrs. / Miss. MOHD KURSHEED ALI UHID / lP No. APJLAO023Z43G7 llp}B!.gts

Was presented with complaints of. ulcer in left cheek region from past six months.

and admitted to Apollo Hospitals under emergency condition on. LO/O,/ZO7B at 11:56 AM

signature and designa*on of ,rMK,"


ln-charge of the case at the Hospital
Date: 12/0Ll20Lg
DT. ARSHEED HUSSAIN
HAKEEM
consu*an t su,
sica i oncr,rnfriLfl?
Resd No. A pnicJni,r#i,d, [:]_l
Apo ilo Ho sp s3B
r ta ts,,ri o ite;'i-llt:,
Hydera ba d- g6.

o,
Dv t{ti$[r?:
n1;*
ti"pi,ilLd-e6
Jubile"
*,'G,Hyd.l

+9'14-28293333, Fax: +91-44-28290956


Regd. Office : Apollo Hospitals Enterprise Limited, No. '19, Bishop Garden, Raja Annamalaipuram, Chennai - 600 028, Teli
Corporate ldentity Number (ClN) : L85110TN1979P1C008035

trl(EED TI{F PFPORTS CAREFULLY AND BRING THEII ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
Apollo Health City Complex, Jubilee Hills, Hyderabad - 500 095; Telangana
Phone : +91-40-2343 1721,2343 1727,2343 1728, Fax : +9L-40-2354 5588
Email : petct@apolloho_spitals.com
www. a po I oh
I ea lth c

(ClN : U85110TN2004PTC052796)
ity. co m/Pet_Sca n/l nd ex. ht m Apollo Gleneagles
PET-CT Centre
I
GSTIN : 36AAECA83 L7RL74 HYDERABAD
GSTIN : 36AAECA831 7R124 OP Cash Bill - Bill of Supply Reference No :

Name : Mr. MOHD IDRIS Age : 39Yr 3Mth 3Days UHID: APJ1.0002324367

Sex : Male
Father Name : MOHD KURSHEED ALI
l lilllll llllll illl llll llil llrill lllil ilililill ilililtil illil Iililtil lilil llll llil

Address : NIZAMABAD Nizamabad Telangana OP Number: OPP5053255


lndia, CellNo:9 1 -9640 21 0246
r 1ililil ililt ilIil til llilt illt ]il ilil1 tilt llll ]ll llil

Bill No : PET-OCS-22865
Doctor's Name DT. PRAS HANT U PADHYAY-OP
Date :.5-Sep-18 Time: 14:30:38
Speciality RADIATION ONCOLOGY
I llilltillilt ililil ililltil] ilt iltill il ill]t illll tffi ililt lillt ]il ilt

Bill Amount: <. 22,000.00 FOR APOLLO HOSPITALS

Amount in words: T Twenty-Two Thousand Only

S.No Service Type/Seruice Name Department Quantity I Amount


1 Investigations(9993)
1 PET CT WHOLE BODY (BASE OF THE SKULL TO Pet CT 1 I 32,o3o.oo
MID THIGHS WITH CONTRAST)
Sub Total 32,030.00

DTARsHEEffis?f#l
& Neck)
tici;l';-7Y tFi*arJ
Consulterrt Silr{ii;:al
uI 53B
Dr. Veera Prakash P. Rffi:-*. nert' cfftu1ltiHrils' Hyderabad'g0'
Apolio Ho$p*ait,
i'U'-e
f, i^Ji^-l O..^^-i^f^^J,

Seruice Amount : A nnlln lJ ne nita lc 32,030.00


Discount ..L:l L^^l (.fa 10,030.00
t , rl

Total Bill Amount 22,000.00

Final Payment (Cash :22.000.00. NonCash : 0.00) 22,000.00

No Tax is Payable on Reverse Charge Basis


Receipt Details: Received with thanks sum of (. 22,000.00 (CASH)

*
(an1
Denotes Gancelled Seryices Ourno@
Denotes Quick Registration
Mr. D HARI BABU t
Cashier

Page 1 of 1

EMERGENCY GALL I 1066


"KEEP THE REPORTS CAREFULLY AND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
Sf Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
m 040-6060 1066
ry apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd Ib@apollohealthcityhyd dfi llo
."n^.-.' ^'.'n,-"tr-.' IFf LISFI f ALU
)nce No :

Name- : Mr. MOHD IDRIS Age : 39Yr 3Mth 2Days UHID: APJ 1 .0002324367

Sex : Male
Father Name : MOHD KURSHEED ALI
l lllill llll] llll ll il!! ililil l]il ilil lIilI illII ililililflffi ililI ]til ililllt

4ddress : NIZAMABAD Nizamabad Telangana OP Number: OPP5049210


I ndia, CellNo: 9 1 -9640210246
I lilllll lffit ilIil il ilil ilil illt! ill! illlt ilIil ilt flil

Bill No : JBH-OCS-1835905
Doctor's Name DR. VIJAY ANAND REDDY P DR PRASHANT
uL
Date : 4-Sep-18 Time : 11 :04:30
Speciality HRflPA+YdX Bft t6I6U YFA
Illilillil lillilllllllil ffirililIililril ililrilil ill]ilflililllil ilillllr

Bill Amount: <. 850.00 FOR APOLLO HOSPITALS

Amount in words: { Eight Hundred Fifty Only

S.No Service Type/Service Name Department Quantity I Amount


1 Consultation(9993)
1 OP Consultation - First Visit I Medical 1 I 850.00
Sub Total 850.00

$'*''
1:.
:r

,*
t t",1

.*[ tr
| (r
,
4
I lk"
i-t.- t[-r-s, -
a i. il

P
Service Amount : "'Y.tl UUpefintenrtanr 850.00
,L i, _^yyrro F,OSpitals

Total Bill Amount 850.00

Final Payment (Cash :850.00, NonCash :0.00) 850.00

No Tax is Payable on Reverse Charge Basis


Receipt Details: Received with thanks sum of (. 850.00 (CASH)

* Denotes Cancelled Services Authorized Signatory


(on1 Denotes Qutelnegistration

Ms. Safia Tadimarri

Gashier
PAN NO: AAACASI'I':'N * TAN NO :HYDAO231 88 * ROHINI ID :89OOO8O328I,,88

Page 1 oJ 1

Regd. Office : Apollo Hospitals Enterprise Limited, No. 19, Bishop Garden, Raja Annamalaipuram, Chennai - 600 028, Teli +91-44-2A293333, Fax: +91-44-28290956
Corporate ldentity Number (ClN) : 18511OTN1979P1C008035

"KEEP THE REPORTS CAREFULLYAND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
$f Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
m 040-6060 1066
ft apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd tr@apollohealthcityhyd
d}
ASbllo
IuosPlrALs

isaha$e-$ummaqt/
Dept.of HEAD & NECK ONCOLOGY
PatientDetails
UHID APJ 1 .0002324367 Name Mr. MOHD IDRIS

Patient Identifier tPzB 1375 Age 39Yr 3Mth 1ZDays

Sex Male Date of 1 0-Sep -2018


Admission

Date of 14-Sep-201 B Address N IZAMABAD, N izanr abad,Telangana

Discharge

Ward/Bed No First Floor , Male General Ward Prilnary DR. ARSHEED H/TKEEM
(CAN),Bed no:MGW-22 Consultant HEAD & NECK ONCOLOGY

Consultants DR. SRIDHAR Y Surgeons DR. ARSHEED HAKEEM


MD HEAD & NECK ONCOLOGY
CRITICAL CARE

Anesthesiologists Dr. SANATH REDDY P


MBBS,MD
AT.JAESTHESIOLOGY

Principal Diagnosis
Diagnosis

Surge ry I Procedures Done

Surgery / Procedure
-
agerq
llrrr -------
rullrHtcKNESS coMPoslrE RESECTIoN lto-sep-2018
----rE4=-------_--
+ MND + i
lFnrn,rc - ---i
-_---- -l---
Details
Diagnosis . CARCINOMA LEFT BUCCAL MUCOSA.

- SOUAMOUS CELL CAP.CINOMA LE[:T BUCCAL MUCOSA

Chief complaint(s) Patient complaints of ulcer in left cheek region frorn past six irroritlts

+9'144-28293333, Fax: +9144-28290956


Regd. Office : Apolto Hospitats Enterprise Limited, No. 19, Bishop Gardeffigq ffigamalaipuram, Chennai - 600 028, Tel
Corporate ldentity Numb-er (ClN) : L8!1 1 0-IN1979PLC008035

.KEEP THE REPORTS CAREFULLYAND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
*b.3.=
$t Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd t@apollohealthcityhyd
ffi
A6bllo
Organization Accredited
by Joint Commission lntemational
InoSPITALS

Present illness history Complaints of ulcer in left buccal mucosa from past 6 months. Which has not
been healing and growing gradually. lt is associated with mild pain. No other
symptoms.

PasUPerconal/FamilY history patient is a tobacco chewer for past 10 years and occasional alcoholic.

.
PHYSICAL EXAMINATION .

Ulcero proliferative growth in left buccal mucosa of 4.5 x 2 cm in size


extending into upper and lower G3 sulcus and infiltrating the fttll thickness
cheek. Muliiple subcentimeter left side level lb and ll nodes.

ir*utment Summary
Discussion PET-CT 4.3 x2.1 cms mass in left buccal mucosa.
Multiple subcentimeter left level lb nodes noted
Biopsy moderately differential squamous cell carcinoma.

Treatment :- Uncler general anaesthesia, standard surgical draping done. Mc


fee incision with upper limb e.xtended to encompass the infil+.rateo skin of left
cheek. Left side full thickness composite resection was done with nrodified
radical neck dissection clearing level l-V cervical lymphnodes. Ttre defect
was reconstructed with PMM ancj flap harvested on left side. Connplete
hemostasis achieved. 2 IVD placed. Wound closed in layers with 3-0 vicryl.
Skin closed with 4-0 ethilon.

Discharge Medication
. TAB. AUGMENTIN 625 MG 1 TAB PER ORAL TWICE DAILY AFTER FOOD FROM 14I}I2O18 TO 19/9/2018
(ANTTBTOTIC)

- TAB. pAN 40 MG 1 TAB pER oRAL oNcE DAtLy 1/2 HR BEFoRE BREAKFAST FRotvl 14lgl2c18To
1stst2o18 (ANTACID)

. TAB. VOVERAN 50 MG 1 TAB PER ORAL TWICE DAILY AFTER FOOD FROM 141912

Discharge Examination
Vitals stable Yes Surgical wound Yes
clean

Ambulatory Yes

r'v
+91-44-28293333, Fax: +91'44'28290956
Regd. office : Apolo Hospitals Enterprise Limited, No. 't9, Bishop Gardec{de_fulrpm-alaipuram, Chennai - 600 028, Iel:
CorPorate ldentity Number (Cl

"KEEP THE REPORTS CAREFULLY AND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
L

Sf Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.


"+_"e*_."
'#,tu."4-

r 040-6060 1066
ffi apollohealthcity@apollohospitals.com
ffiapollohealthcity ffiapollohealthhyd t{@apollohealthcityhyd
ffi www.apollohealthcity.com Dj-
Organization Accredited
by Joint Commission lntemational
ASbllo
InosPtrALs

:DAMA/DOR/LAMA
None

Spe-cial Instructions
Diet SOFT DIET.

Follow-up instruc{ion TO REPORT ON 2OI9I2O18 AT DR. HAKEEM OPD AT 3 PM.

Physical activity DILUTE chlorhexidine mouthwash 4th hourly to keep oral cavity clean.

**********************************************tt*!t?b***rt*******!htk************************
Emergency Care

::?*?::::.=-:?.Yl:l**************************************************************
******** * *******tt* * *** rr****

**lN CASE YOU HAVE .FEVER (101 F).NEW ONSET PAIN OR


WORSENING OF EXISTING PAIN.VOMITINGS.DIFFICULTY IN
BREATHING.ALTERED LEVEL OF CONSCIOUSNESS
.WORSENING OF ANY OF YOUR SYMPTOMS.ANY OTHER
SIGNI FICANT COM PLAI NTS

** PLEASE CALL EMERGENCY SERVICES AT . 1066 . 04060601066 (Call


Centre) . 04023607777 AND ASK FOR YOUR DOCTOR / EMERGENCY
**
ROOM / EXTENSION NUMBER IF KNOWN

** IN CASE YOU DONOT UNDERSTAND YOUR DISCHARGE


MEDICATIONS AND / OR NOTICE ANY NEW REACTION TO YOUR
MED|CATIONS, PLEASE CALL 9177400151 I 04023607777-63 14**

*" FOR YOUR APPOINTMENTS, SCHEDULED OR OTHERWISE, CALL


ouR. CALL CENTER (04060601066) .040236A7777 **

************************************************************************rk**************

***************************

7>/'
xIiTXtrl:yefuAqr$tE-$.
T\usb "&
P ri m ary
fi *.ffiFEU [:I'ntt[.tl
o ;.ad'e.

ptease unoerstino you, Jii"niigi pi"iCiipiir; iiom yil ooctoi uetore using tne medicines.
R"g 90956
Typed by 1066422 Corporate ldentity N Blldt 9851 1 OTN 1 979P1C008035

"KEEP THE REPORTS CAREFULLY AND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
$f Apollo Health City campus, Jubibe Hills, Hyderabad - 500 096.
m +91-1860 2sB 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd ht@apollohealthcityhyd
ffi
ASbllo
InosplrALs

DEPOSIT RECEIPT

Uhid : APJ1.0002324367 Patient ldentifier : 1P281375 Receipt No : 10950383

Patient Name : Mr. MOHD IDRrS


Receipt Date :
10-Sep-2018 12:10:01 pm
AddreSS: NIZAMABAD Nizamabad
. Telangana India
lllil ilIil llill illt Iilil lllll ilil illl ilil illt

Transaction Tlpe : DEpOSIT

Transaction Amount : 1001000.00

lnstrument Number Transaction Amount


100,000.00

Received with Thanks Rs : 100,000.00


Rupees One Hundred Thousand only (INR) From Mr. MOHD IDRIS

Rem a TKs : INTIAL DEPOSIT.


NOTE: All Payments lncluding Dr.Fees Shoutd be Paid at
Bllling Gounter Onty

vtt[IqlSth P'
--.o*-ld-

Dr.
Dy:-^ii,j[i:t1',1ffi
Hyde
Jubilee'Hills'

Regd. Offtce : Apollo Hospitals Enterprise Limited, No. 19, Bishop Garden, Raja Annamalaipuram, Chennai - 600 028, Tel: +91-4-28293333, Fax: +91-44-28290956
Corporate ldentity Number (ClN) : 185110TN1979PLC008035

"KEEP THE REPORTS CAREFULLY AND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
$f Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi[ www.apollohealthcity.com
ffi apollohealthcity ffiapollohealthhyd b@ apollohealthcityhyd
ffi
Organization Accredited
by Joint Commission lnternational
A6buo
lnosPrrALs
DEPOSIT RECEIPT

Uhid : APJ 1.0AA2324367 Patientldentifier: 1P281375 Receipt No : 10973304

Patient Name : Mr. MOHD IDRIS


Receipt Date :
14-Sep-2018 5:36:23 pm
AddreSS: NIZAMABAD Nizamabad
Telangana India
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Transaction Type : DEPOSIT

Transaction Amount : 901000.00

Mode Of Payment lnstrument Number Transaction Amount


CASH 90,000.00

Received with 'fhanks Rs : 90,000.00


Rupees Ninety Thousand only (INR) From Mr. MOHD IDRIS
Remarks:

NOTE: All Payments lncluding Dr.Fees Should be Paid at Billing Counter Only

;ilxrw.gl*I
Htrit' HYO"
Jubite"

Regd. Office : Apollo Hospitals Enterprise Limited, No. 19, Bishop Garden, Raja Annamalaipuram, Chennai - 600 028, Teli +9144-28293333, Fax: +91-44-28290956
Corporate ldentity Number (ClN) : 1851 1OTN1979P1C008035

"KEEP THE REPORTS CAREFULLYAND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
$f Apollo Health city campus, Jubilee Hills, Hyderabad - 500 096.
m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffi apollohealthcity ffiapollohealthhyd rr@ apoiloheatthcityhyd ffi
AObllo IHOSPITALS
GSTIN : 36AAACA5443N3ZH
ln Patient Bill - Bill of Su Reference No :
Name : Mr. MOHD IDRIS Age: 39Yr 3Mth 12Days
Sex: Male UHID : APJ1.0002324367

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Fathli Name : MOHD KURSHEED ALI

Address : NIZAMABAD Nizamabad relangana lndia, cell lP Number: 1P281375


No:91-9640210246
I lllilil ilffit ilt ililt ilil ililt ililt ffiil ]il ilt

'Doctor Name : DR. ARSHEED HAKEEM Bill No : JBH-ICS-120027


Speciality : HEAD & NECK ONCOLOGY
Ward Name . Male Generat Ward (CAN) Date : 14-Sep-2018 Time : 1T:3g:22
Bed No : MGW-22 (Generat)
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Billing Account Type : CASH Admission Date : 1O-Sep-2018 11:56:36 am


Discharge Date : 14-Sep-2018 10:53:38 am

SL. No Service
Amount(lNR)
1 Assistant Doctor Fee(9993)
1,700.00
2 Assistant Surgeon Fee(9993)
10,100.00
3 Consultation(9993)
1,000.00
4 Drug Administration Charges(ggg3)
2,200.00
5 lnvestigations(ggg3)
10,310.00
6 Medical Administration(99g3)
1,250.00
7 Medical Services(9993)
6,000.00
B Nutritional and Functionar Assessment charges(9gg3) 1,400.00
I OT Charges(9993)
68,040.00
10 OT Consumabtes(9993)
11 OT Pharmacy(9993) 11 ,723.93
5,651.58
12 Professional Charges(9993)
56,000.00
13 Room Rent(9993)
10,600.00
14 Ward consumables(OT stores)(g993)
2,120.00
15 Ward Pharmacy(9993)
11 ,964.19

Servi eAm
Total Discount
10,060.00

Total Bill Amount Cash:0.00 NonCash:0.00 190,000.00

1 09503g3,1 0g+ Cash :1 g0, 000. oo, NonCaS'fi itiloo

Net

ffi*$H Em w*rds : Rup*s$ Sns Lakhs hdimety Thousand


Ant*u.tmt Only
No Tax is Payable on Reverse Charge Basis

Mr. Y.Koteswar Rao


Mr. Y.Kotes
Generated By
Resd' office : Apollo Hospitals enterprifdff4{G{4ftF.45f6ilficip ttrydue;H6fuaffiefiilraiipE0fl{lvf{Sfflgg0ffi&ilt1gret:+e1-44-282e3333, Fax: +e1-44-
lN) : 1851 1 OTN1 979P1C008035

of 10
"KEEP THE REPORTS CAREFULLYAND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL''
%*

ffi
$f Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd hlffilapollohealthcityhyd

Organization Accredited
by Joint Commission lntemational
A6bllo
lnosPrrAls
tlame : Mr. MOHD IDRIS lP No : 1P281375 Bill No : JBH-ICS-120A27
il.No Service Service Name Start Date End Date Dr Name otv Amount(lNR)
Code ( Order No.
Ass istant,?ff::l Fee(eee3) 1,700.00
1,700.00
1 8410 ASSISTANT DOCTOR FEE 1,700.00

Assistant Surgeon Fee(ggg3) 1 0,1 00.00


Medical
. 10,100.00
, 1 e303 ASSISTANT SURGEON FEE
10,100.00

Consultation(9993) 1,000.00
Consultation 1,000.00
1 38071 ICU Visit Charges DR. SRIDHAR Y 1,000.00
(cRrTtcAL CARE)
Drug Administration Charges(9993) 2,20A.00
Nursing 2,200.00
1 5740 Drug administration Charges 2,200.00

lnvestigations(9993) 10,310.00
Haematology 900.00
1 46 HEMOGLOBIN (AUTOMATION) 440.00
(s562572)
2 99 TOTAL LEUCOCYTE COUNT (TLC) 360.00
(5s62s72)
Histopathology
8,400.00
3 6265 FRoZEN SECTIoN WITH PARAFFIN 3,500.00
FOLLOW UP
(s561758)
4 6546 TVVO LARGE SPECIMENS
4,900.00
(556208s)
X Ray
1,110.00
5 1224 BED SIDE X-RAY CHESTAP DR. ICU DOCTOR 1 ,110.00
(20es862) (cRrTrcAL CARE)
Medical Adm i n istration(9993) 1,250.00
Medical Records
1,250.00
1 2114 Medical Records 1,250.00

Medical Services(9993) 6,000.00


Medical
6,000.00
1 1077592 Hospital Services and rreatment Monitoring
1,500.00 -

and Management Charges

2 10775e2 Hospital services and rreatment Monitoring


1,500.00
and Management Charges

3 1077592 Hospital services and rreatment Monitoring


1,500.00
and Management Charges

4 1077592 Hospital services and rreatment Monitoring


1 1,500.00
and Management Charges

Nutritional and Functional Assessment charges(ggg3) 1,400.00


Nursing
1,400.00
1 5742 Nutritionat and Functional Assessment 1 1,400.00

Regd. Office : Apollo Hospitals Enterprise Limited, No. 'lg, Bishop Garden, Raja Annamalaipuram, Chennai - 600 028, Teli +9144-28293333, Fax: +9'144-28290956
: 1851 1 OTN 1 979P1C008035

of 10
"KEEP THE REPORTS CAREFULLYAND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
'+",
$f Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.

ffi
i@1
m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi[ www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd hfi@apollohealthcityhyd

Organization Accredited
by Joint Commission lntemational
ASbllo
luosPlrALs
tlame : Mr. MOHD IDRIS lP No : IP281375 Bill No : JBH-ICS-120027
OT Charges(9993) 68,040.00
1 O-Sep -2018
General Surgery 68,040.00
1- -2103 Operation Theatre Charges 10-Sep-2018 10-Sep-2018 1 68,040.00
(12877e8) 14:50.00 19:30.00

OT Consumables(9993) 11,723.83
Opefation Theatre 11,723.83
1 ZIIqIOO ACCUTOUCH POWDER FREE GLOVE 5 450.00
000036e 6.0-SENT!NEL
. 5oo (PM|S01563751)
2774700 ACCUTOUCH POWDER FREE GLOVE 5 450.00
000036e 6.5-SENT|NEL
soo (PM|S01s63751 )
2774700 ACCUTOUCH POWDER FREE GLOVE 8 720.00
000036e 7.o-SENTINEL
5oo (PM|So1563751)
4 2774700 ACCUTOUCH POWDER FREE GLOVE 5 450.00
000036e 7.s-SENTINEL
soo (PM|So1563751)
5 2774700 DERMARK SURGTCAL SKIN MARKER 1 248.00
0000322 (ROMSONS)-(HSN:901 89099)
3oo (PM|S01s63751)
6 2774700 E.C.G ELECTRODES AMBU . 30.00
oooo32e (HSN.90189099)
8oo (PM|S015637s1)
V 10117OO ETHILON 3-O SN 3328 SUTURE 6 966.00
000032e INDIA(HSN:901 83990)
4oo (PM|So1563751 )
8 2774loo EXAMTNATTON GLOVES - 10 60.00
000024e GLOVEON(HSN :4015901 0)
600 (PM|S01563751 )
9 2774700 FACE MASK BIOSAFE, 10 75.00
000022e MEDICUB(HSN:901 91 090)
600 (PMrS01563751)
10 2774700 GLOVES DR.CHOICE(HSN :40151 1 00) 4s.00
oooo733 (PM|So1563751)
30
11 2774700 LAP SPONGE 30.30 PLY STERILE I 12 560.04
0000322 DOCTOR CHOTCE-(HSN:30050000)
3oo (PM1501563751)
12 10117OO MERSILK 3.0 NW 5O2B ETHICON. 1 176.00
0000506 (HSN:901 99099)
30 (PMIS01563751)
13 10117OO MERSUTURE 2-O NW 4245 ETHICON. 2 288.00
0000s66 (HSN:901S9019)
40 (PM|S01563751 )
14 2774700 NASAL TUBE PORTEX SIZE 7.5 1 1,000.00
oooo571 (PMtso1563751)
90
15 2774700 OXYGEN RECOVERY KIT 60% - 1 375.00
0000430 vtNJo(HSN:901 91 090)
30 (PMIS01563751)
16 1.09e+o RELIANT DISPOSABLE PENCIL W HOLSTER 1 393.1 2
17 VL261O COVIDIEN
(PMrS01563751)
17 1oB21oo SCRATCH PAD-. AMS 1 269.89
0000 1 49 (PMrS01 563751)
700

Regd. Office : Apollo Hospitals Enterprise Limited, No. 19, Bishop Garden, Raja Annamalaipuram, Chennai - 600 028, Tel: +9'144-28293333, Fax:
+9144-28290956

of 10

"KEEP THE REPORTS CAREFULLY AND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
- 500 096'
$f Apollo Health City campus, Jubilee Hills, Hyderabad
m 040-6060 1066

rlame : Mr. MOHD IDRIS


ffi apollohealthcity@apollohospitats.com ffi www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd h@apollohealthcityhyd

IP No : 1P281375
Organization Accredited
by Joint Commission lntemational

Bill No :
ffi llo
PITALS

JBH-ICS- 120027
18 2774700 STOP COCK 3-WAY (100CM) - BD 1 211 .00
oooo l 2g-) (PMtsol 563751 )
900
19
- ZIIIIOO STOP COCK 3-WAY l OCM
1 175.00
0000266 POLYMED(HSN:901 83990)
3oo (PM|S01563751)
20 2774loo SURGEON CAP (BIOSAFE , MEDICUB) 10 75.00
0000234 (HSN'.621030e0)
300 (PMrS01563751)
21 zr7 4loo SYRINGE WITH NEEDLE lOML DISPO 93.30
0000233 (NTPRO)
600 (PMrS01563751)
22 277 4700 SYRINGES zCC B.D(HSN:901 831 00) 47.50
oooo4l e (PMtso1563751 )
40
23 2774700 SYRINGES sCC B.D(HSN:90183100) 60.00
oooo423 (PMISo1563751)
20
24 00 TEGADERM 1624 3M(HSN :30059060)
277 47
66.00
aooa427 (PMISo1 563751 )
70
25 2774700 THERMOVENT HEPAFILTERS - PORTEX- 1 475.00
0000322 (HSN:90183990)
3oo (PMtS015637s1)
26 2774700 vAsoFrx I.V.CANNULAE 2oc 1 193'00
0000428 B.BRAUN(HSN:901 83900)
60 (PMISo1563751)
27 tol2loo vrcRyL 2rs 24TBSUTURES |NDIA 2 620'98
oooo167 (PMtsol563751)
700
2a 1o117oovrcRyL 2-o NW 2404 ETHrcoN. 1 635'00
0000s66 (HSN:90189099)
so (PM|So1563751)
29 1o117oo VtcRYL 2-O NW 2404 ETHICON - 2 1'270.00
0000s66 (HSN:90189099)
50 (PM|So1s637s1)
30 1011700 V|CRYL2-O TSP 2317 SUTURE 2 1'246.00
0000346 INDIA(HSN:901 83990)
ooo (PMISo1 563751)

OT Pharmacy(9993) 5'651'58
1o-seP-2018
4,980'58
'1 INJ(HSN:30049087) 10-Sep-2018
3118s ADVENT 1.2GM 'l 131'99
(PM1N0115145878) 20:04-20
2 18330 AIR WAY 2G (POLYMEDXHSN:9018) 10-Sep-2018 1 110.00
(PM1N0115145878) 20:04.20
3 64110 ATRAPURE 25MG/2.5M1INJ(HSN:30049099) 10-Sep-20't8 2 272.48
(PM1N0115145878) 20:04.20
4 75777 AUTOFUSTON SETWTH 10-Sep-2018 1 252.00
Y-SITE(HSN:90219090) 20:04.20
(PMlN0115'145878)
5 5OOML (P) B.BXHSN:30049099) 10-Sep-2018
1471s D.N.S 1 67 -17

(PM1N0115145878) 20:04.20
6 3036 DC ALCOHOL SWAB OoS #(HSN:90189099)
1 l GSep-2018 I 16.00

(PM1N0115145878) 20:O4.20
7 s178s DERIPHYLLIN 2ML INJ(HSN:30049094) 10-Sep-2018 1 s.70
(PM1N0115145878) 20:04.20
8 48417 DEMSONE 2 ML INJ(HSN:30043913) 10-Sep-2018 1 5.98
028, rel +91-44-28293333, Fax: +9144-28290956
Regd. ofltB&4lNprtff,65fiffid Enterprise Limited, No. 19, Bishop Garde0ffiF2onamalaipuram, chennai - 600

of 10

-KEEP THE REPORTS CANETITLI-YITIO ERING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
$f Apollo Health city campus, Jubilee Hills, Hyderabad - s00 096.
m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffi apollohealthcity ffiapollohealthhyd rrl@ apoiloheatthcityhyd
ffi
A\6bllo
THOSPITALS
tlame : Mr. MOHD IDRIS lP No :1P281375 Bill No : JBH-ICS- 120027
9 53984 DRESSING PACK KIT (STARN4EDD 10-Sep-2018 -1 210.00
#(HSN:3005) 20:04.20
(PMtNo1 15145878)
1O- 43265 FOLEYS CATHETER 2 WAY 14 (A)
RUSH(HSN:9018)
10-Sep-2018 1 t08.00
20:04.20
(PMtN0 115145878)
11 25472 GLANPAN 40MG tNJ(HSN:30049039) 10-Sep-2018
4s.00
(PMrN01 15145878) 20:04.20
12 71705 H - coRT - 100 MG INJ(HSN:30043200) 10-Sep-2018
37.05
(PMtN0 115145878) 20:04.20
13 49943 JUSTIN 75MG/3ML INJ(HSN:300A9066) 10-Sep-2018 4.40
(PMtN0115145878) 20:04.20
14 33s00 LAStx 2oMG 2ML |NJ(HSN:30049079) 10-Sep-2018 3.36
(PMrN0 11514s878) 20:04.20
15 253s1 LOX 4o/o TOPICAL 3OML 10-Sep-2018 32.90
SOL(HSN:30039034) 20:04.20
(PMtN01 15145878)
16 5e438 MALTDENS 1ooML 1MG rV(HSN:300a9063)
(PMtN01 1514s878)
1O-Sep-2018 1 989.00
20:04.20
17 34618 METOLAR sML |NJ(HSN:30049074) 1O-Sep-2018 14.85
(PMtN011s145878) 20:04.20
18 4561s MYOSTIGMIN SML 2.5MG 10-Sep-2018 22iA
INJ(HSN:3003903a) 2A:04.20
(PMtN01 1 514sB7B)
19 4457a MYoSIGMtNE 1 ML(HSN:30039034) 1O-Sep-2018 4.40
(PMtN01 1s14s878) 20:A4.20
20 73603 ONDOKTND 2MG/ML tNJ 4 ML(HSN:300a) 10-Sep-2018 23.75
(PMtN01 1s145878) 20:04.20
21 41046 PYROLATE tNJ 10-Sep-2018
35.85
(G LYCO PYROLATE HS N : 30049034)
(
2A:04.20
(PMtN0 115145878)
22 14493 RINGER LACTATE sOOML PLASTIC (B / 10-Sep-2018 92.22
BRAUN)(HSN:30049099) 20:04.20
(PMtN0 11514s878)
23 s8885 ROMOLENE FG 16(HSN:90183990) 1O-Sep-2018
57.00
(PMtN0115145878) 20.04.20
24 47052 ROMOVAC SET 14 (ROMSON)
(HSN:90189099)
10-Sep-2018 1 671 .00
20:A4.20
(PMtN0115145878)
25 45378 SEVORANE 250 ML(HSN:20a00001)
(PMtN0115145878)
10-Sep-2018 30 890.40
20:04.20
26 27341 SOOIUM CHLORIDE O 9% sOOML ( B BRAUN 10-Sep-2018
74.28
XHSN:300a9099) 20:04.20
(PMtN0 115145878)
27 36819 SODIUM CHLORIDE lOOOML (NIRLIFE) 10-Sep-2018 95.1 6
(HSN:30045020) 20:04.20
(PMtN0115145878)
28 57777 STANDARD GOWN XL #(HSN:62101OOO)
(PMtN0 11s145878)
10-Sep-2018 1 3s0.00
20:04.20
2e 638 51
1 4c (poLyMED) 10-Sep-2018
56.00
:#J^lt?T;orrErER 20:04.20
(PMtN0 11s14s878)
30 52211 SURGICAL BLADE 10-.Sep-2018
12.00
21G(SURGEO(HSN:9018) 20:04.20
(PMtN01 1s145878)

Regd. Office : Apollo Hospitals Enterprise Limited, No. 19, Bishop Garden, RajaAnnamalaipuram, Chennai - 600 028, Tel +9'144-28293333, Fax: +9144-28290956

of 10
..KEEP
THE REPORTS CAREFULLY AND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
ffi
$f Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
t:.r:,:,,,,'

m 040-6060 1066.
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd h@lapollohealthcityhyd
Abbllo
lnosPrrALs
tlame : Mr. MOHD IDRIS lP No.: 1P281375 Bill No : JBH-ICS-120027
31 64042 SURGICAL BLADES NO 15 10-Sep-2A18 4 120.00
(SWAN N-MORTON XHS N : 90 1 8) 20.04.20
(PMtN0 11514s878)
3i. .48512 URoMETER(PoLYMEDXHSN:9O18) 10-Sep-2018 1 400.00
(PMtN0115145878) 20:04.20
s3 17072 VASOCON (ADRENALINE) 10-Sep-2018 1 15.90
INJ(HSN:30033900) 20:04.20
(PMtN01 15145878)
34 45139 WATER FOR INJECTION lOML (NIRMA) 10-Sep-2018 4.64
(HSN:300a9099) 20:04.20

35 6844' [T,,i,]x:lffi,3,l sEr (BREATHE) 10-Sep-2018 1 350.00


(HSN:9018) 20:04.20
(PMtN01 15145878)
11-Sep -2018

671.00
1 47052 ROMOVAC SET 14 (ROMSON) 11-Sep-2018 1 671 .00
(HSN:90189099) 8:54.39
(PMrN011 5147880)
Profess iona I C ha rges(ggg3) 56,000.00
Anaesthesiology
9,000.00
1 2122 Anaesthesiologist Fees Dr. SANATH 1 9,000.00
(12877e8) REDDY P
(ANAESTHESTOLO
GY)
General Surgery
49,000.00
2 2121 Surgeon Fees DR. ARSHEED 1 49,000.00
(12877e8) HAKEEM (HEAD &
NECK ONCOLOGY)
Room Rent(9993) 10,600.00
Wards Others
10,600.00
1 2127 ROOM RENT(General) 1 2,650.00

2 2127 ROOM RENT(Generat) 3 7,950.00

Ward cons umables(OT storesXggg3) 2120.A0


Anaesthesiology
212A.00
1 6s65 GENERAL ANAESTHESTA 1 2,120.00
(1287798)
Ward Pharmacy(ggg3) 11 ,964.1 9
10-Sep-2018
5,237.51
1 55002 ACTICO THTGH LENGTH-M 10-Sep-2018 1 2,000.00
#(HSN:61155990) 21:51 .52
(PMtso114765916)
2 31188 ADVENT 1 .2GM INJ(HSN:30049087) 10-Sep-2018 2 263.98
(PMrS01 14765979) 21:53.36
3 53882 Ap THERMOMETER 10-Sep-2018 1 19s.00
DIGITAL#(HSN :90251 91 0) 21:51 .52
(PMtS0114765916)
4 32925 EMESET 8MG 4ML INJ(HSN:30049035) 10-Sep-2018 23,79
(PMtS011476s979) 21:53.36
5 604es KAB|MoL 1% soML(HSN:300a9061) 1O-Sep-z}ft 2 393 80
(PMlS01 1476s97e) 21:53.36
6 44634 NASOCLEAR NASAL SpRAy 10-Sep-2018 40.00
20ML(HSN:30049069) 21:54.02
nego. ofdBJ4lf;8Jrfuafr65ffF$ Enterprise Limited, No. 19, Bishop carden, Raja Annamalaipuram, Chennai - 600 028, reti +s144-2a2g3333, Fax: +91-44-2g290956

of 10
"KEEP THE REPORTS CAREFULLYAND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
ffi
+311..*
$f Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffi apollohealthcity ffiapollohealthhyd h@l apollohealthcityhyd

Organization Accredited
by Joint Commission lntemational
ASbllo
InosplrAls
tlame : Mr. MOHD IDRIS lP No :
1P281375 Bill No : JBH-ICS-120027
7 s8se3 NITRILE
GLOVES (EVER Cnreruj 10-Sep-2018 30 360.00
#(HSN '.401s1 1 00) 21:51 .52
(PMtso1 1476s916)
8_ _23661 PETHIDINE- 100MG/2ML tNJ 1O-Sep-zAft 1 112.00
(HSN:300a9099) 15:39.09
(PMrN0115144280)
9 44746 RANTAC 25MG 2ML INJ(HSN:3OOA9O33) 10-Sep-2018 3.40
(PM rS01 1476s979) 21:53.36
1O 27341 SOOIUM CHLORIDE 0.9% sOOML ( B BRAUN 10-Sep-2018 5 \ 371.30
)(HSN:30049099) 21:51 .52
(PMtso1 1 476s91 6)
11 206a4 SYRINGE 20ML (NtpRO) WO/N(HSN:9O18) 10-Sep-2018 5 175.00
(PMrS0 114765916) 21 .51 .52
12 40465 SYRINGES 1gML BD (D,SCARD,T) 10-Sep-2018 5 110.00
(HSN:90183100) 21:51 .52
(PMrS01 14765916)
13 40830 SYRINGES SOML NIPHRO(HSN:9018) 10-Sep-2018 3 450.00
(PMrS01 14765916) 21:51 .52
14 42123 SYRINGES SML B.D.(HSN:90183100) 10-Sep-2018 60.00
(PMrS01 1476591 6) 21:51 .52
15 71827 TEGADERM tV 6.S.7CM 10-Sep-2A18 1 162.00
1683(HSN:30051020) 21:51.52
(PMtS01 1 4765e1 6)
16 28s46 TROFENTYL 2ML INJ(HSN:30049099) 10-Sep-2018 92.24
(PMtN0115144280) 15:39.09
17 72117 VIGGOFLO FLOW REGULATOR(HSN:9018) 10-Sep-2018 1 425.00
(PMrS0 11476s916) 21:51.52
11-Sep -2018
2,772.64
1 2s345 364376 A-LINE TM SAMPLING KtT 11-Sep-2018 2 16s.00
3(HSN:9018) 15:41 .11
(PMrS01 14770571)
2 31188 ADVENT 1 .2cM INJ(HSN:300a9087) 11-Sep-2018 2 263.98
(PMrS01 14768010) 10:46.54
3 42066 CD SITE SUCTIONE SET(HSN:9O18) 11-Sep-2018 1 280.00
(PMrS0114767334) 7:08.12
4 26643 DC GAUZE BANDAGE 1,CMX4M 11-Sep-2018 16.00
#(HSN:30050000) 7:08.12
(PMrS01 14767334)
5 6814e DC WET WtpES##(HSN:9619) 11-Sep-2018 1 130.00
(PMrS0114772020) 21:42.49
6 22s6s INTp4FIX SAFE SET 180CM(HSN:9018) 11-Sep-2018 1 244.00
(PMrS0 114772020) 21:42.49
7 4ee43 JUSTTN 75MG/3ML tNJ(HSN:30049066) 11-Sep-zAft 8.80
(PMtS0114768010) 10:46.54
8 58se3 NITRILE GLOVES (EVER GREEN) 11-Sep-2018 20 240.A0
#(HSN:4A151100) 21:42.49
(PMtS0114772A20)
9 42451 OXYGEN MASK (ADULT) VINJOH 2028 11-Sep-2018 1 295 00
#(HSN:90192090) 15:41.11
(PMtso114770571)
10 44746 RANTAC 25MG 2ML |NJ(HSN:300a9033) 11-Sep-2018 6.80
(PMrS011476801 0) 10:46.54
11 52178 RESOURCE OPTI VANILLA 4OOGM 11-Sep-2018 1 650.00
POWDER(HSN 21069099) 1 3:1 2.41
(PMtS0114768894)
Regd. Office : Apollo Hospitals Enterprise Limited, No. 19, Bishop Garden, Raja Annamalaipuram, Chennai - 600 028, Teli +9144-28293333, Fax: +9144-28290956

of 10

"KEEP THE REPORTS CAREFULLYAND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
$f Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd h@lapollohealthcityhyd
ffi
A6bl lo
Organization Accredited
by Joint Commission lntemational IHOSPITALS
rlame : Mr. ,VIOHO IDRIS lP No :
1P281375 Bill No : JBH-IC3-120027
12 16154 SODIUMCHLOR;DE0.g./@ 11-Sep-2018 35.52
(HSN:300a9099) 7:08.12
(PMtS0114767334)
13-
-16154 SODIUM CHLORIDE O.9o/o 10OML B(BRAUN) 11-Sep-2018 71.04
(HSN:30049099) 21:42.49
(PMtS0114772020)
14 s1638 sucTtoN CATHETER 14c (POLYMED) 11-Sep-2018 3 168.00
(HSN:9018) 10:50.19
(PMrS0 114768164)
15 40724 SYRINGES 2ML B.D(HSN:901S3100) 11-Sep-2018 28.50
(PMtso1 14770571) 15.41 .11
16 42125 SYRINGES SML D|SPOVAN(HSN:901 BgA22) 11-Sep-2018 13.00
(PM tso1 14772020) 21:42.49
17 63523 TEGADERM- 8526 IN(HSN:30051090) 11-Sep-2018 1 157.00
(PMtS0 114770s71) 15:41 .11
12-Sep -2018

1,566.92
1 31188 ADVENT 1 .2cM |NJ(HSN:300a9097) 12-Sep-2018 2 263 98
(PMrS0 11477 4s13) 11:32.31
2 7s777 AUTOFUSION SET W,TH 12-Sep-2018 1 2s2.00
Y-SITE(HSN :90219090) 22:13.49
(PMtso114777826)
3 6814e DC WET WPES##(HSN:9019) 12-Sep-2018 1 130.00
(PMtso1 14777826) 22:13.49
4 4ee43 JUSTTN 75MG/3ML tNJ(HSN:300a9066) 12-Sep-2A18 8.80
(PMtS0114774513) 11:32.31
5 58593 NITRILE GLOVES (EVER GREEN) 12-Sep-2018 10 120.00
#(HSN '.40151 1 00) 22:13.49
(PMrS0114777826)
6 44746 RANTAC 2sMG 2ML tNJ(HSN:300a9033) 12-Sep-2018 6.80
(PMrS01 14774s13) 11:32.31
7 s2178 RESOURCE OPT' VANTLLA 400GM 12-Sep-zAft 1 650.00
POWDER(HSN:21 069099) 8:35.34
(PMrS0 114773427)
8 39652 SODIUM CHLORIDE 9% lOOML (NIRLIFE) 12-Sep-2018 33.24
(HSN:30045020) 22:13.49
(PMtS0114777826)
9 40465 SYRINGES lOML BD (DISCARDIT) 12-Sep-2018 22.00
11:32.28
[ffit3?]:;;:31.,
1O 40465 SYRINGES l OML BD (DISCARDIT) 12-Sep-2018 44.0A
(HSN:90183100) 22:13.49
(PMtS0114777826)
11 42123 SyRtNGES sML B.D.(HSN:90183100) 12-Sep-zAfi 12.00
(PMtso114774536) 11:32.28
12 42123 SYRINGES sML B. D.(HSN:901 83100) 12-Sep-2018 24.00
(PMtS01 14777826) 22:13.49
13-Sep -2A18

1,607.21
1 31188 ADVENT 1.2GM INJ(HSN:30049087) 13-Sep-2018 1 131.99
(PMrS01 1477e375) 10:31 .19
2 18476 BENADRYL COUGH FORMULA 13-Sep-2018 90.00
150ML(HSN:30045039) 10:31 .19
(PMtso1 1477937s)
3 7s703 BIO BATH 10 S#(HSN:96190000) 13-Sep-2018 90.00
(PMtso1 14782523) 22"29.39

Regd. Office : Apollo Hospitals Enterprise Limited, No. 19, Bishop Garden, Raja Annamalaipuram, Chennai - 600 028, Tel. +g'l-44-29293333, Fax: +91-44-28290956

of 10

"KEEP THE REPORTS CAREFULLY AND BRING THEM ALONG DURING YOUR NEXT VISIT TO OUR HOSPITAL"
$f Apollo Health city campus, Jubilee Hills, Hyderabad - 500 096. h;or"rr*,,

m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffi apollohealthcity ffiapoiloheatthhyd h@ apoiloheatthcityhyd ffL_
A0bllo
THOSPITALS
!ruqe : rvi MoHD tDRrs lP No : lP2813Ts
4 31 803
CLOHEX - MOUTH WASH Bill No : JBH-tcs- 120027
13-Sep-2018
1SOML(HSN:30049087) 102.00
1A31 .24
(PMtS0 114779373)
5 49943 JUSTIN 75MG/3ML
INJ(HSN:30049066) 13-Sep-2019
(PMtso 114779375)
10:31 .19
I 4.40
6 4ee43 JUSTTN 75MG/3ML rNJ(HSN:30049066)
13-Sep-2018
I 4.40
10:31 .19
T ioroo ffiH:JJ ':':,Y#JcLovES 1oo 13-Sep-2018
'S-N832(GLOVEONXHSN :401
590 1 O)
10 60.00
22:29.39
(PMrS0 114782523)
B 44746 RANTAC 25MG 2MLINJ(HSN:30049033)
13-Sep-2018
(PMtso 114779375) 6.80
10:31 .19
9 52178 RESOURCE OPTI VANILLA
4OOGM 13-Sep-2018
PO\A/DE R(HS N :2 1 069099)
9:28.17
1 650.00
(PMrS0114779124)
1O 39652 SODIUM CHLORIDE 9% lOOML (NIRLIFE) 13-Sep-2018
(HSN:300a5020) 16.62
10:31 .24
(PMtS0 114779373)
11 4046s SvRINGES 1oML BD (DtscARDtr) 13-Sep-2018
(HSN:90183100) 44.00
10:31 .24
(PMtS0 114779373)
12 7e0e SYRTNGES soML(Top PLASTTCXHSN:9018)
13-Sep-201A
(PMtso 114782s23) 1 130.00
22:29.39
13 7909 SYRINGES sOML(TOP PLASTICXHSN:9o18)
13-Sep-201A
(PMtS0 114782613) 1 130. OO
22:52.03
14 42123 SyRtNGES sML B.D.(HSN:90183100) 13-Sep-2018
(PMtS0 11477s373) 24.00
10:31 .24
15 60628 TEGADERM 7X8.5CM 1633(HSN:30051020) 13-Sep-2018
(PMtS0114782613) 1 123. OO
22:52.03
14-Sep -2019

52178 RESoURCE oPTI 790.00


VANILLA 4OOGM 14-Sep-2018
POWDER(HSN:21 069099) 6s0.00
9:14.23
(PMtso 114783729)
7909 SYRINGES5OML(TOPPLASTICXHSN:9018)
14-Sep-2018
(PMtS0114783387) 130.00
(B) indicates bedside service
6:12.35
($) indicates stat service
E) indicates dead patient Grand Total 200,059.59
?upees Two Lakhs Sixty Only
Bed Details
Sl.No I
From Date To Date Duration
1 | 10-Sep-2018 11:56 am 11-Sep-2018 12:00 am 0Days 12Hrs 3MiG
Bed No Bed Ca
INTREC3 General
2 11-Sep -2018 12:00 am 11-Sep -2018 12:33 pm 0Days 12Hrs 33Mins SICU4 ICU
3 11-Sep -2018 12:33 pm 14-Sep-2018 10:S3 am 2Days 22Hrs 2OMins MGW-22 General

Regd' office : Apollo Hospitals Enterprise Lim',"d' Garden,.Raja^Annamataipuram, chennai - 600 028, Tet: +9144-28293333,
P.-]9: ?l",nop Fax: +9144-28290956

of 10
.KEEPTHEREPoRTscAREFULLYANDBRlNGTHEMALoNGo
$f Apollo Health City campus, Jubilee Hills, Hyderabad - 500 096.
m 040-6060 1066
ffi apollohealthcity@apollohospitals.com ffi www.apollohealthcity.com
ffiapollohealthcity ffiapollohealthhyd h@lapollohealthcityhyd

rlame, nfr. MOHD IDRIS lP No : 1P281375 Bill No : JBH-IC3-120027


Sl No. Doctor's Name Specialization OT Request No
1 DT. SANATH REDDY P ANAESTHESIOLOGY 1287798
2 . DR. ARSHEED HAKEEM HEAD & NECK ONCOLOGY 1287798

Dr" ARSHE ED hlUSSAIhi FiAKEIM


MS(ENT), FtjNS
Consr;iiant Surglce! cncclogy (iiead & Neck)

A
Regd. l{0. AP lvi C/FM RiSBS 3B
Apoilo Hospitais, Jubilee Hills, Hyderabad-96.

Dr. Veera Piaka?h ?,


ovl n r eo icai s u Perintendent
APollo HosPitals'
Jubilee HiiG, Hyderabad-96'

Regd. Office : Apollo Hospitals Enterprise Limited, No. 19, Bishop Garden, RajaAnnamalaipuram, Chennai - 600 028, Tel: +91-44-28293333, Fax: +91-44-28290956

of 10
"KEEP THE REPORTS CAREFULLY AND BRING THEM ALONG DUR]NG YOUR NEXT VISIT TO OUR HOSPITAL'

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