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:: Expenses Bill Annexure (A) :: | {{-- |
:: Expenses Bill Annexure (D/L) :: | --}}
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:: Expenses Bill Annexure (A) :: |
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| Policy No. : {{$response['policy_number']}} | Patient Name : {{$response['petient_name']}} |
| Policy Holder Name : {{$response['policy_holder_name']}} | Claim Lodged Type : {{$response['claim_lodged_type']}} |
| A: Hospital Bills | ||||
| Bill Date | Bill Number | Amount | Bill Issued By Name | Remarks |
|---|---|---|---|---|
| {{ $value1['billDate'] }} | {{ $value1['billNum'] }} | {{ $value1['billAmt'] }} | {{ $value1['billIssuedByName'] }} | {{ $value1['billRemark'] }} |
| Total : | {{ $response['hospitalise_bill_total'] }} | |||
| B: Pharmacy - Medicine Bills | ||||
| Bill Date | Bill Number | Amount | Bill Issued By Name | Remarks |
|---|---|---|---|---|
| {{ $value2['billDate'] }} | {{ $value2['billNum'] }} | {{ $value2['billAmt'] }} | {{ $value2['billIssuedByName'] }} | {{ $value2['billRemark'] }} |
| Total : | {{ $response['pharmacy_medicine_bill_total'] }} | |||
| C : Lab-X'Ray - Investigation Bills | ||||
| Bill Date | Bill Number | Amount | Bill Issued By Name | Remarks |
|---|---|---|---|---|
| {{ $value3['billDate'] }} | {{ $value3['billNum'] }} | {{ $value3['billAmt'] }} | {{ $value3['billIssuedByName'] }} | {{ $value3['billRemark'] }} |
| Total : | {{ $response['lab_xray_bill_total'] }} | |||
| D : Other Hospitalised Exp. Bills | ||||
| Bill Date | Bill Number | Amount | Bill Issued By Name | Remarks |
|---|---|---|---|---|
| {{ $value4['billDate'] }} | {{ $value4['billNum'] }} | {{ $value4['billAmt'] }} | {{ $value4['billIssuedByName'] }} | {{ $value4['billRemark'] }} |
| Total : | {{ $response['other_hospitalise_exp_bill_total'] }} | |||
| Grand Total : | {{ $response['bill_grand_total'] }} | |||