Dr. Lal PathLabs Ltd.

Page 1
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Date Name Lab No. Gross Amount Revenue Share Discount Net Amount

01/05/19   DEEPA 265709914 190.00 33.00 0.00 157.00
01/05/19   ISHAN 265709913 70.00 21.00 0.00 49.00
01/05/19   JYOTI 265709912 320.00 96.00 0.00 224.00
01/05/19   RAMESHWARI 265709918 1,799.00 0.00 899.00 900.00
01/05/19   SIDDESH 265709919 130.00 15.00 0.00 115.00
01/05/19 ANITA  JAIN 265709910 1,269.00 21.00 499.00 749.00
01/05/19 ANITA  JAIN 265709917 600.00 60.00 0.00 540.00
01/05/19 ASHA  BAJPAY 265709906 120.00 36.00 0.00 84.00
01/05/19 EKTA  DUBEY 265709909 1,260.00 378.00 0.00 882.00
01/05/19 GEETA  SINGH 265709908 2,059.00 18.00 899.00 1,142.00
01/05/19 RAJWANTI  SHRIVASTAVA 265709911 550.00 0.00 550.00 0.00
01/05/19 SONI  KUMARI 265709904 2,499.00 210.00 899.00 1,390.00
01/05/19 UDYAN  BAJPAI 265709905 670.00 201.00 0.00 469.00
01/05/19 USHA  NAIR 265709907 120.00 36.00 0.00 84.00
01/05/19 VIJAY  SINGH 265709916 400.00 120.00 0.00 280.00
01/05/19 VISHAKHA  KASHIV 265709915 1,080.00 324.00 0.00 756.00
02/05/19   JYOTI 265709924 600.00 60.00 0.00 540.00
02/05/19 BINOY  GEORGE 265709921 2,059.00 18.00 899.00 1,142.00
02/05/19 O P AGARWAL 265709923 180.00 54.00 0.00 126.00
02/05/19 PRANAV  SINGH 265709920 550.00 165.00 0.00 385.00
02/05/19 VARSHA  VERMA 265709925 170.00 51.00 0.00 119.00
02/05/19 VEENA  KALRA 265709922 390.00 117.00 0.00 273.00
03/05/19   HARSHITA 265709938 660.00 118.00 0.00 542.00
03/05/19 AMIT  DAS 265709927 450.00 135.00 0.00 315.00
03/05/19 AMITABH  SUR 265709932 590.00 153.00 0.00 437.00
03/05/19 BINOY  GEORGE 265709929 160.00 0.00 160.00 0.00
03/05/19 BINOY  GEORGE 265709930 70.00 21.00 0.00 49.00
03/05/19 GEETA  SINGH 265709935 1,500.00 450.00 0.00 1,050.00
03/05/19 JAS  SHRIVASTAV 265709936 1,495.00 390.00 0.00 1,105.00
03/05/19 K.G.  SONI 265709926 1,199.00 0.00 499.00 700.00
03/05/19 KALPANA  PATEL 265709928 250.00 40.00 0.00 210.00
03/05/19 PANCHWATI  PATHAK 265709937 625.00 145.00 0.00 480.00
03/05/19 RAHUL  SUR 265709934 530.00 135.00 0.00 395.00
03/05/19 S. K. SUR 265709933 1,199.00 0.00 499.00 700.00
03/05/19 T. P. GOUTAM 265709931 330.00 99.00 0.00 231.00
04/05/19   SHUBHAM 265709941 260.00 78.00 0.00 182.00
04/05/19 AMIT  PATHAK 265709939 500.00 150.00 0.00 350.00
04/05/19 ANITA  JAIN 265709942 400.00 120.00 0.00 280.00
04/05/19 PADAM SINGH PAL 265709940 530.00 135.00 0.00 395.00
05/05/19   REKHA 265709945 260.00 78.00 0.00 182.00
05/05/19 EKTA  AGARWAL 265709943 2,059.00 18.00 899.00 1,142.00
05/05/19 PRIYA  JAROLIYA 265709946 1,999.00 0.00 899.00 1,100.00
05/05/19 R. K. AGARWAL 265709944 1,259.00 18.00 499.00 742.00
06/05/19   JAYRAM 265709956 80.00 24.00 0.00 56.00
06/05/19   JYOTI 265709947 200.00 60.00 0.00 140.00
06/05/19   KARUNA 265709953 5,879.00 1,404.00 499.00 3,976.00
06/05/19   REKHA 265709955 60.00 18.00 0.00 42.00
06/05/19 ALPANA  BAJPAI 265709951 130.00 28.00 0.00 102.00
06/05/19 CHANDRAKANTA  SAXENA 265709954 120.00 36.00 0.00 84.00
06/05/19 KAMLA  TIWARI 265709948 650.00 171.00 0.00 479.00
06/05/19 MAMTA  VERMA 265709949 2,059.00 18.00 899.00 1,142.00
06/05/19 SEEMA  SUR 265709952 350.00 105.00 0.00 245.00
07/05/19   DAYAWANTI 265709958 470.00 141.00 0.00 329.00
07/05/19   RACHNA 265709962 120.00 0.00 120.00 0.00
07/05/19   RACHNA 267639462 120.00 36.00 0.00 84.00
07/05/19 CHANDRAKANTA  SAXENA 265709960 550.00 165.00 0.00 385.00
07/05/19 CHANDRAKANTA  SAXENA 267639001 60.00 18.00 0.00 42.00
07/05/19 DHIRENDRA  SAAD 265709957 2,350.00 705.00 0.00 1,645.00
07/05/19 DIVYA  VERMA 267639469 330.00 75.00 0.00 255.00
07/05/19 JYOTI  VERMA 267639470 670.00 153.00 0.00 517.00
07/05/19 NEERU  SAXENA 265709964 260.00 78.00 0.00 182.00
07/05/19 POONAM  SAKYA 267639463 500.00 150.00 0.00 350.00
07/05/19 RAKESH  SAXENA 265709961 320.00 96.00 0.00 224.00
07/05/19 U.K  BELWALKAR 265709959 130.00 15.00 0.00 115.00
48,818.00 7,813.00 9,618.00 31,387.00
 Dr. Lal PathLabs Ltd. Page 2
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Gross Amount ................: 48,818.00

Discount Amount ............: 9,618.00
Revenue Share ..............: 7,813.00
TDS (@ 10.00 %) .........:        782.00
Total Payable Amount ....: 32,169.00

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd.
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
SAC NO..............................: 999316

Invoice Print Date .............: 08/05/2019

Invoice Period ...................: 01­05­2019 ­ 07­05­2019
11,REGAL TRESURE GRAM 
NARELA SHANKRI, AYODHYA
BYPASS ROAD BHOPAL­462041
,
HUZUR,
BHOPAL462041
MAD ,IND

Dear Sir / Madam,
We are enclosing the bill pertaining to the tests undergone by employees/patients of your organization 
for the period from  01­05­2019 to 07­05­2019
If any discrepancy/Adjustment/Deduction on account of TDS or any other deduction made at the time of 
payment, Please attach a summary statement of deduction with the payment.
Kindly remit the total payable amount (32,169.00) at the earliest through NEFT/RTGS/ Fund transfer as 
per details given below.
BENEFICIARY NAME  : DR LAL PATHLABS LIMITED
BANK NAME  : HDFC BANK LTD
BANK ACCOUNT NUMBER  : DRLALPC004277226
BRANCH NAME  : SANDOZ BRANCH, MUMBAI
IFSC CODE  : HDFC0000240

Thanking you
Yours Truly
For Dr. Lal PathLabs Ltd.

(Authorised Signatory)
PAN NO – AAACD3377J
TAN NO – DELD03576G
Note :
1. This is a computer generated bill and does not require signature/stamp.
2. Please do not make payment in cash ,we shall not be responsible for loss in cash handling.
3. Please use below mentioned deposit slip to deposit Cheque/DD in our HDFC Bank
4. Please fill Cheque No.,Cheque Date, Drawee Bank and Amount in below deposit Slip.
5. Dr. Lal PathLabs Ltd. is exempt from GST being a healthcare service provider.
Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204

CORPORATE PRODUCT & SERVICES Local Outstation Transfer

Company Name ­                       DR LAL PATHLABS LIMITED Date Deposit Slip No ­

Client Code                                                     LALPATHLAB Location
Sr no. Drawer Name Drawer Code Cheque No Cheque dateDrawee Bank DrawnLocation Amount
1 BHOPAL CC 39­SUSHIL KUMAR MALVIYA C004277226
2
3
Total
Count Of Cheques

Depositor's Signature Teller Signature
Depositor Name & Contact Number
 Dr. Lal PathLabs Ltd. Page 1
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Name: RAJWANTI  SHRIVASTAVA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 U027 MICROALBUMIN, 1ST MORNING / RANDOM URINE

265709911 550.00 0.00 550.00 0.00
Total for Patient : RAJWANTI  SHRIVASTAVA 550.00 0.00 550.00 0.00

Name: SONI  KUMARI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 WM16 SWASTH SUPER 3 265709904 1,799.00 0.00 899.00 900.00

01/05/2019 Z318 LipidProfileScreen 265709904 0.00 0.00 0.00 0.00
01/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709904 0.00 0.00 0.00 0.00
01/05/2019 Z284 THYROIDPROFILETOTAL( 265709904 0.00 0.00 0.00 0.00
01/05/2019 R119 VITAMIND25HYDROXY 265709904 0.00 0.00 0.00 0.00
01/05/2019 R047 VITAMINB12CYANOCOBAL 265709904 0.00 0.00 0.00 0.00
01/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709904 200.00 60.00 0.00 140.00
01/05/2019 B066 MAGNESIUMSERUM 265709904 500.00 150.00 0.00 350.00
Total for Patient : SONI  KUMARI 2,499.00 210.00 899.00 1,390.00

Name: UDYAN  BAJPAI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 B021 UREA , SERUM 265709905 80.00 24.00 0.00 56.00

01/05/2019 B023 CREATININESERUM 265709905 100.00 30.00 0.00 70.00
01/05/2019 B045 POTASSIUMSERUM 265709905 160.00 48.00 0.00 112.00
01/05/2019 B001 GLUCOSEFASTING(F) 265709905 60.00 18.00 0.00 42.00
01/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709905 200.00 60.00 0.00 140.00
01/05/2019 U001 URINEEXAMINATIONROUT 265709905 70.00 21.00 0.00 49.00
Total for Patient : UDYAN  BAJPAI 670.00 201.00 0.00 469.00

Name: GEETA  SINGH
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 WM17 SWASTH SUPER 4 265709908 1,999.00 0.00 899.00 1,100.00

01/05/2019 Z318 LipidProfileScreen 265709908 0.00 0.00 0.00 0.00
01/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709908 0.00 0.00 0.00 0.00
01/05/2019 Z284 THYROIDPROFILETOTAL( 265709908 0.00 0.00 0.00 0.00
01/05/2019 R047 VITAMINB12CYANOCOBAL 265709908 0.00 0.00 0.00 0.00
01/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709908 0.00 0.00 0.00 0.00
01/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709908 0.00 0.00 0.00 0.00
01/05/2019 R119 VITAMIND25HYDROXY 265709908 0.00 0.00 0.00 0.00
01/05/2019 B001 GLUCOSEFASTING(F) 265709908 60.00 18.00 0.00 42.00
Total for Patient : GEETA  SINGH 2,059.00 18.00 899.00 1,142.00

Name: EKTA  DUBEY
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 R119 VITAMIND25HYDROXY 265709909 1,100.00 330.00 0.00 770.00

01/05/2019 B042 CALCIUMSERUM 265709909 160.00 48.00 0.00 112.00
Total for Patient : EKTA  DUBEY 1,260.00 378.00 0.00 882.00

Name: ANITA  JAIN
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 WM15 SWASTH SUPER 2 265709910 1,199.00 0.00 499.00 700.00

01/05/2019 Z318 LipidProfileScreen 265709910 0.00 0.00 0.00 0.00
01/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709910 0.00 0.00 0.00 0.00
01/05/2019 Z284 THYROIDPROFILETOTAL( 265709910 0.00 0.00 0.00 0.00
01/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709910 0.00 0.00 0.00 0.00
Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd. Page 2
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709910 0.00 0.00 0.00 0.00

01/05/2019 U001 URINEEXAMINATIONROUT 265709910 70.00 21.00 0.00 49.00
Total for Patient : ANITA  JAIN 1,269.00 21.00 499.00 749.00

Name:   JYOTI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709912 200.00 60.00 0.00 140.00

01/05/2019 H030 MALARIAPARASITEBLOOD 265709912 120.00 36.00 0.00 84.00
Total for Patient :   JYOTI 320.00 96.00 0.00 224.00

Name:   ISHAN
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 U001 URINEEXAMINATIONROUT 265709913 70.00 21.00 0.00 49.00

Total for Patient :   ISHAN 70.00 21.00 0.00 49.00

Name: ASHA  BAJPAY
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 B001 GLUCOSEFASTING(F) 265709906 60.00 18.00 0.00 42.00

01/05/2019 B002 GLUCOSEPOSTPRANDIAL( 265709906 60.00 18.00 0.00 42.00
Total for Patient : ASHA  BAJPAY 120.00 36.00 0.00 84.00

Name:   DEEPA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 Z284 THYROIDPROFILETOTAL( 265709914 130.00 15.00 0.00 115.00

01/05/2019 B003 GLUCOSERANDOM(R) 265709914 60.00 18.00 0.00 42.00
Total for Patient :   DEEPA 190.00 33.00 0.00 157.00

Name: USHA  NAIR
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 B001 GLUCOSEFASTING(F) 265709907 60.00 18.00 0.00 42.00

01/05/2019 B002 GLUCOSEPOSTPRANDIAL( 265709907 60.00 18.00 0.00 42.00
Total for Patient : USHA  NAIR 120.00 36.00 0.00 84.00

Name: VISHAKHA  KASHIV
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 Z019 HEMOGRAM *CBC * ESR 265709915 250.00 75.00 0.00 175.00

01/05/2019 S028 IMMUNOGLOBULINIgESER 265709915 830.00 249.00 0.00 581.00
Total for Patient : VISHAKHA  KASHIV 1,080.00 324.00 0.00 756.00

Name: VIJAY  SINGH
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 P027 SPUTUMEXAMINATIONAFB 265709916 400.00 120.00 0.00 280.00

Total for Patient : VIJAY  SINGH 400.00 120.00 0.00 280.00

Name: ANITA  JAIN

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd. Page 3
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 S225 DENGUEANTIGENNS1 265709917 600.00 60.00 0.00 540.00

Total for Patient : ANITA  JAIN 600.00 60.00 0.00 540.00

Name:   RAMESHWARI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 WM16 SWASTH SUPER 3 265709918 1,799.00 0.00 899.00 900.00

01/05/2019 Z318 LipidProfileScreen 265709918 0.00 0.00 0.00 0.00
01/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709918 0.00 0.00 0.00 0.00
01/05/2019 Z284 THYROIDPROFILETOTAL( 265709918 0.00 0.00 0.00 0.00
01/05/2019 R119 VITAMIND25HYDROXY 265709918 0.00 0.00 0.00 0.00
01/05/2019 R047 VITAMINB12CYANOCOBAL 265709918 0.00 0.00 0.00 0.00
Total for Patient :   RAMESHWARI 1,799.00 0.00 899.00 900.00

Name:   SIDDESH
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

01/05/2019 Z284 THYROIDPROFILETOTAL( 265709919 130.00 15.00 0.00 115.00

Total for Patient :   SIDDESH 130.00 15.00 0.00 115.00

Name: PRANAV  SINGH
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

02/05/2019 Z367 LIVERPANELSCREEN 265709920 350.00 105.00 0.00 245.00

02/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709920 200.00 60.00 0.00 140.00
Total for Patient : PRANAV  SINGH 550.00 165.00 0.00 385.00

Name: BINOY  GEORGE
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

02/05/2019 WM17 SWASTH SUPER 4 265709921 1,999.00 0.00 899.00 1,100.00

02/05/2019 Z318 LipidProfileScreen 265709921 0.00 0.00 0.00 0.00
02/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709921 0.00 0.00 0.00 0.00
02/05/2019 Z284 THYROIDPROFILETOTAL( 265709921 0.00 0.00 0.00 0.00
02/05/2019 R047 VITAMINB12CYANOCOBAL 265709921 0.00 0.00 0.00 0.00
02/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709921 0.00 0.00 0.00 0.00
02/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709921 0.00 0.00 0.00 0.00
02/05/2019 R119 VITAMIND25HYDROXY 265709921 0.00 0.00 0.00 0.00
02/05/2019 B001 GLUCOSEFASTING(F) 265709921 60.00 18.00 0.00 42.00
03/05/2019 B042 CALCIUM, SERUM 265709929 160.00 0.00 160.00 0.00
Total for Patient : BINOY  GEORGE 2,219.00 18.00 1,059.00 1,142.00

Name: O P AGARWAL
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

02/05/2019 B021 UREA , SERUM 265709923 80.00 24.00 0.00 56.00

02/05/2019 B023 CREATININESERUM 265709923 100.00 30.00 0.00 70.00
Total for Patient : O P AGARWAL 180.00 54.00 0.00 126.00

Name:   JYOTI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

02/05/2019 S225 DENGUEANTIGENNS1 265709924 600.00 60.00 0.00 540.00

Total for Patient :   JYOTI 600.00 60.00 0.00 540.00

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd. Page 4
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Name: VEENA  KALRA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

02/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709922 200.00 60.00 0.00 140.00

02/05/2019 U001 URINEEXAMINATIONROUT 265709922 70.00 21.00 0.00 49.00
02/05/2019 B001 GLUCOSEFASTING(F) 265709922 60.00 18.00 0.00 42.00
02/05/2019 B002 GLUCOSEPOSTPRANDIAL( 265709922 60.00 18.00 0.00 42.00
Total for Patient : VEENA  KALRA 390.00 117.00 0.00 273.00

Name: VARSHA  VERMA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

02/05/2019 S006 PREGNANCYTESTURINE 265709925 170.00 51.00 0.00 119.00

Total for Patient : VARSHA  VERMA 170.00 51.00 0.00 119.00

Name: K.G.  SONI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 WM15 SWASTH SUPER 2 265709926 1,199.00 0.00 499.00 700.00

03/05/2019 Z318 LipidProfileScreen 265709926 0.00 0.00 0.00 0.00
03/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709926 0.00 0.00 0.00 0.00
03/05/2019 Z284 THYROIDPROFILETOTAL( 265709926 0.00 0.00 0.00 0.00
03/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709926 0.00 0.00 0.00 0.00
03/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709926 0.00 0.00 0.00 0.00
Total for Patient : K.G.  SONI 1,199.00 0.00 499.00 700.00

Name: BINOY  GEORGE
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 U001 URINEEXAMINATIONROUT 265709930 70.00 21.00 0.00 49.00

Total for Patient : BINOY  GEORGE 70.00 21.00 0.00 49.00

Name: AMIT  DAS
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709927 350.00 105.00 0.00 245.00

03/05/2019 B023 CREATININESERUM 265709927 100.00 30.00 0.00 70.00
Total for Patient : AMIT  DAS 450.00 135.00 0.00 315.00

Name: KALPANA  PATEL
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 Z318 LipidProfileScreen 265709928 180.00 30.00 0.00 150.00

03/05/2019 R052 TSHTOTAL 265709928 70.00 10.00 0.00 60.00
Total for Patient : KALPANA  PATEL 250.00 40.00 0.00 210.00

Name: T. P. GOUTAM
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 B021 UREA , SERUM 265709931 80.00 24.00 0.00 56.00

03/05/2019 Z019 HEMOGRAM *CBC * ESR 265709931 250.00 75.00 0.00 175.00
Total for Patient : T. P. GOUTAM 330.00 99.00 0.00 231.00

Name: AMITABH  SUR

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd. Page 5
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 B001 GLUCOSEFASTING(F) 265709932 60.00 18.00 0.00 42.00

03/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709932 350.00 105.00 0.00 245.00
03/05/2019 Z318 LipidProfileScreen 265709932 180.00 30.00 0.00 150.00
Total for Patient : AMITABH  SUR 590.00 153.00 0.00 437.00

Name: S. K. SUR
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 WM15 SWASTH SUPER 2 265709933 1,199.00 0.00 499.00 700.00

03/05/2019 Z318 LipidProfileScreen 265709933 0.00 0.00 0.00 0.00
03/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709933 0.00 0.00 0.00 0.00
03/05/2019 Z284 THYROIDPROFILETOTAL( 265709933 0.00 0.00 0.00 0.00
03/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709933 0.00 0.00 0.00 0.00
03/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709933 0.00 0.00 0.00 0.00
Total for Patient : S. K. SUR 1,199.00 0.00 499.00 700.00

Name: RAHUL  SUR
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 Z318 LipidProfileScreen 265709934 180.00 30.00 0.00 150.00

03/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709934 350.00 105.00 0.00 245.00
Total for Patient : RAHUL  SUR 530.00 135.00 0.00 395.00

Name: GEETA  SINGH
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 M010 CULTURE, AEROBIC, BLOOD, RAPID 265709935 1,100.00 330.00 0.00 770.00

03/05/2019 M007 CULTUREURINEIncludes 265709935 400.00 120.00 0.00 280.00
Total for Patient : GEETA  SINGH 1,500.00 450.00 0.00 1,050.00

Name: JAS  SHRIVASTAV
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 Z190 RUBELLA(GERMANMEASLE 265709936 1,050.00 315.00 0.00 735.00

03/05/2019 R082 PROLACTINSERUM 265709936 145.00 25.00 0.00 120.00
03/05/2019 Z045 THYROIDPROFILEFREE*F 265709936 300.00 50.00 0.00 250.00
Total for Patient : JAS  SHRIVASTAV 1,495.00 390.00 0.00 1,105.00

Name: PANCHWATI  PATHAK
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709937 350.00 105.00 0.00 245.00

03/05/2019 Z284 THYROIDPROFILETOTAL( 265709937 130.00 15.00 0.00 115.00
03/05/2019 R082 PROLACTINSERUM 265709937 145.00 25.00 0.00 120.00
Total for Patient : PANCHWATI  PATHAK 625.00 145.00 0.00 480.00

Name:   HARSHITA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

03/05/2019 R047 VITAMINB12CYANOCOBAL 265709938 420.00 70.00 0.00 350.00

03/05/2019 Z284 THYROIDPROFILETOTAL( 265709938 130.00 15.00 0.00 115.00
03/05/2019 H001 HEMOGLOBINHb 265709938 110.00 33.00 0.00 77.00
Total for Patient :   HARSHITA 660.00 118.00 0.00 542.00

Name: AMIT  PATHAK

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd. Page 6
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

04/05/2019 S026 WIDALSLIDEAGGLUTINAT 265709939 250.00 75.00 0.00 175.00

04/05/2019 Z106 BILIRUBINTOTALDIRECT 265709939 250.00 75.00 0.00 175.00
Total for Patient : AMIT  PATHAK 500.00 150.00 0.00 350.00

Name: PADAM SINGH PAL
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

04/05/2019 Z318 LipidProfileScreen 265709940 180.00 30.00 0.00 150.00

04/05/2019 Z367 LIVERPANELSCREEN 265709940 350.00 105.00 0.00 245.00
Total for Patient : PADAM SINGH PAL 530.00 135.00 0.00 395.00

Name:   SHUBHAM
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

04/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709941 200.00 60.00 0.00 140.00

04/05/2019 B001 GLUCOSEFASTING(F) 265709941 60.00 18.00 0.00 42.00
Total for Patient :   SHUBHAM 260.00 78.00 0.00 182.00

Name: ANITA  JAIN
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

04/05/2019 M007 CULTUREURINEIncludes 265709942 400.00 120.00 0.00 280.00

Total for Patient : ANITA  JAIN 400.00 120.00 0.00 280.00

Name: EKTA  AGARWAL
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

05/05/2019 WM17 SWASTH SUPER 4 265709943 1,999.00 0.00 899.00 1,100.00

05/05/2019 Z318 LipidProfileScreen 265709943 0.00 0.00 0.00 0.00
05/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709943 0.00 0.00 0.00 0.00
05/05/2019 Z284 THYROIDPROFILETOTAL( 265709943 0.00 0.00 0.00 0.00
05/05/2019 R047 VITAMINB12CYANOCOBAL 265709943 0.00 0.00 0.00 0.00
05/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709943 0.00 0.00 0.00 0.00
05/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709943 0.00 0.00 0.00 0.00
05/05/2019 R119 VITAMIND25HYDROXY 265709943 0.00 0.00 0.00 0.00
05/05/2019 B001 GLUCOSEFASTING(F) 265709943 60.00 18.00 0.00 42.00
Total for Patient : EKTA  AGARWAL 2,059.00 18.00 899.00 1,142.00

Name: R. K. AGARWAL
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

05/05/2019 WM15 SWASTH SUPER 2 265709944 1,199.00 0.00 499.00 700.00

05/05/2019 Z318 LipidProfileScreen 265709944 0.00 0.00 0.00 0.00
05/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709944 0.00 0.00 0.00 0.00
05/05/2019 Z284 THYROIDPROFILETOTAL( 265709944 0.00 0.00 0.00 0.00
05/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709944 0.00 0.00 0.00 0.00
05/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709944 0.00 0.00 0.00 0.00
05/05/2019 B001 GLUCOSEFASTING(F) 265709944 60.00 18.00 0.00 42.00
Total for Patient : R. K. AGARWAL 1,259.00 18.00 499.00 742.00

Name:   REKHA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

05/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709945 200.00 60.00 0.00 140.00

05/05/2019 B001 GLUCOSEFASTING(F) 265709945 60.00 18.00 0.00 42.00

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd. Page 7
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Total for Patient :   REKHA 260.00 78.00 0.00 182.00

Name: PRIYA  JAROLIYA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

05/05/2019 WM17 SWASTH SUPER 4 265709946 1,999.00 0.00 899.00 1,100.00

05/05/2019 Z318 LipidProfileScreen 265709946 0.00 0.00 0.00 0.00
05/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709946 0.00 0.00 0.00 0.00
05/05/2019 Z284 THYROIDPROFILETOTAL( 265709946 0.00 0.00 0.00 0.00
05/05/2019 R047 VITAMINB12CYANOCOBAL 265709946 0.00 0.00 0.00 0.00
05/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709946 0.00 0.00 0.00 0.00
05/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709946 0.00 0.00 0.00 0.00
05/05/2019 R119 VITAMIND25HYDROXY 265709946 0.00 0.00 0.00 0.00
Total for Patient : PRIYA  JAROLIYA 1,999.00 0.00 899.00 1,100.00

Name:   JYOTI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

06/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709947 200.00 60.00 0.00 140.00

Total for Patient :   JYOTI 200.00 60.00 0.00 140.00

Name: KAMLA  TIWARI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

06/05/2019 Z284 THYROIDPROFILETOTAL( 265709948 130.00 15.00 0.00 115.00

06/05/2019 B024 URIC ACID, SERUM 265709948 100.00 30.00 0.00 70.00
06/05/2019 B072 RHEUMATOIDFACTOR(RA) 265709948 420.00 126.00 0.00 294.00
Total for Patient : KAMLA  TIWARI 650.00 171.00 0.00 479.00

Name: MAMTA  VERMA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

06/05/2019 B001 GLUCOSEFASTING(F) 265709949 60.00 18.00 0.00 42.00

06/05/2019 WM17 SWASTH SUPER 4 265709949 1,999.00 0.00 899.00 1,100.00
06/05/2019 Z318 LipidProfileScreen 265709949 0.00 0.00 0.00 0.00
06/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709949 0.00 0.00 0.00 0.00
06/05/2019 Z284 THYROIDPROFILETOTAL( 265709949 0.00 0.00 0.00 0.00
06/05/2019 R047 VITAMINB12CYANOCOBAL 265709949 0.00 0.00 0.00 0.00
06/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709949 0.00 0.00 0.00 0.00
06/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709949 0.00 0.00 0.00 0.00
06/05/2019 R119 VITAMIND25HYDROXY 265709949 0.00 0.00 0.00 0.00
Total for Patient : MAMTA  VERMA 2,059.00 18.00 899.00 1,142.00

Name: ALPANA  BAJPAI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

06/05/2019 R052 TSHTOTAL 265709951 70.00 10.00 0.00 60.00

06/05/2019 B001 GLUCOSEFASTING(F) 265709951 60.00 18.00 0.00 42.00
Total for Patient : ALPANA  BAJPAI 130.00 28.00 0.00 102.00

Name: SEEMA  SUR
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

06/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709952 350.00 105.00 0.00 245.00

Total for Patient : SEEMA  SUR 350.00 105.00 0.00 245.00

Name:   KARUNA

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd. Page 8
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

06/05/2019 WM15 SWASTH SUPER 2 265709953 1,199.00 0.00 499.00 700.00

06/05/2019 Z318 LipidProfileScreen 265709953 0.00 0.00 0.00 0.00
06/05/2019 Z025 LIVER&KIDNEYPANEL*LF 265709953 0.00 0.00 0.00 0.00
06/05/2019 Z284 THYROIDPROFILETOTAL( 265709953 0.00 0.00 0.00 0.00
06/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 265709953 0.00 0.00 0.00 0.00
06/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709953 0.00 0.00 0.00 0.00
06/05/2019 H009 ESR(WESTERGREN)ERYTHROCYTESEDI 265709953 130.00 39.00 0.00 91.00
06/05/2019 B074 CREACTIVEPROTEINCRP 265709953 380.00 114.00 0.00 266.00
06/05/2019 B072 RHEUMATOIDFACTOR(RA) 265709953 420.00 126.00 0.00 294.00
06/05/2019 B149 ANTICYCLICCITRULLINA 265709953 1,750.00 525.00 0.00 1,225.00
06/05/2019 S044 ANTI NUCLEAR  ANTIBODY / FACTO 265709953 2,000.00 600.00 0.00 1,400.00
Total for Patient :   KARUNA 5,879.00 1,404.00 499.00 3,976.00

Name: CHANDRAKANTA  SAXENA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

06/05/2019 B001 GLUCOSEFASTING(F) 265709954 60.00 18.00 0.00 42.00

06/05/2019 B002 GLUCOSEPOSTPRANDIAL( 265709954 60.00 18.00 0.00 42.00
Total for Patient : CHANDRAKANTA  SAXENA 120.00 36.00 0.00 84.00

Name:   REKHA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

06/05/2019 B002 GLUCOSEPOSTPRANDIAL( 265709955 60.00 18.00 0.00 42.00

Total for Patient :   REKHA 60.00 18.00 0.00 42.00

Name:   JAYRAM
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

06/05/2019 B021 UREA , SERUM 265709956 80.00 24.00 0.00 56.00

Total for Patient :   JAYRAM 80.00 24.00 0.00 56.00

Name:   DAYAWANTI
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 M007 CULTUREURINEIncludes 265709958 400.00 120.00 0.00 280.00

07/05/2019 U001 URINEEXAMINATIONROUT 265709958 70.00 21.00 0.00 49.00
Total for Patient :   DAYAWANTI 470.00 141.00 0.00 329.00

Name: DHIRENDRA  SAAD
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 L004 HLAB27FLOWCYTOMETRY 265709957 2,350.00 705.00 0.00 1,645.00

Total for Patient : DHIRENDRA  SAAD 2,350.00 705.00 0.00 1,645.00

Name: U.K  BELWALKAR
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 Z284 THYROIDPROFILETOTAL( 265709959 130.00 15.00 0.00 115.00

Total for Patient : U.K  BELWALKAR 130.00 15.00 0.00 115.00

Name: CHANDRAKANTA  SAXENA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 Z367 LIVERPANELSCREEN 265709960 350.00 105.00 0.00 245.00

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd. Page 9
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
BHOPAL CC 39­SUSHIL KUMAR MALVIYA PAN Number......................: BUHPM9298J
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709960 200.00 60.00 0.00 140.00

Total for Patient : CHANDRAKANTA  SAXENA 550.00 165.00 0.00 385.00

Name: NEERU  SAXENA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 B001 GLUCOSEFASTING(F) 265709964 60.00 18.00 0.00 42.00

07/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709964 200.00 60.00 0.00 140.00
Total for Patient : NEERU  SAXENA 260.00 78.00 0.00 182.00

Name: DIVYA  VERMA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 267639469 200.00 60.00 0.00 140.00

07/05/2019 Z284 THYROIDPROFILETOTAL( 267639469 130.00 15.00 0.00 115.00
Total for Patient : DIVYA  VERMA 330.00 75.00 0.00 255.00

Name: JYOTI  VERMA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 Z318 LipidProfileScreen 267639470 180.00 30.00 0.00 150.00

07/05/2019 Z284 THYROIDPROFILETOTAL( 267639470 130.00 15.00 0.00 115.00
07/05/2019 B023 CREATININESERUM 267639470 100.00 30.00 0.00 70.00
07/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 267639470 200.00 60.00 0.00 140.00
07/05/2019 B001 GLUCOSEFASTING(F) 267639470 60.00 18.00 0.00 42.00
Total for Patient : JYOTI  VERMA 670.00 153.00 0.00 517.00

Name:   RACHNA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 B001 GLUCOSEFASTING(F) 267639462 60.00 18.00 0.00 42.00

07/05/2019 B002 GLUCOSEPOSTPRANDIAL( 267639462 60.00 18.00 0.00 42.00
07/05/2019 B001 GLUCOSE, FASTING (F) 265709962 60.00 0.00 60.00 0.00
07/05/2019 B002 GLUCOSE, POST PRANDIAL (PP), 2 HOURS265709962 60.00 0.00 60.00 0.00
Total for Patient :   RACHNA 240.00 36.00 120.00 84.00

Name: POONAM  SAKYA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 B080 HbA1c(GlycosylatedHaemoglobin) 267639463 350.00 105.00 0.00 245.00

07/05/2019 G010 GLUCOSETOLERANCETESTORAL 267639463 150.00 45.00 0.00 105.00
Total for Patient : POONAM  SAKYA 500.00 150.00 0.00 350.00

Name: RAKESH  SAXENA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 B001 GLUCOSEFASTING(F) 265709961 60.00 18.00 0.00 42.00

07/05/2019 B002 GLUCOSEPOSTPRANDIAL( 265709961 60.00 18.00 0.00 42.00
07/05/2019 Z021 COMPLETE BLOOD COUNT;CBC 265709961 200.00 60.00 0.00 140.00
Total for Patient : RAKESH  SAXENA 320.00 96.00 0.00 224.00

Name: CHANDRAKANTA  SAXENA
Date Test Code Test Code Lab No. Gross Amt. Revenue Share Discount Net Amount

07/05/2019 B002 GLUCOSEPOSTPRANDIAL( 267639001 60.00 18.00 0.00 42.00

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
 Dr. Lal PathLabs Ltd. Page 10
Corporate Office: 12th Floor, Tower–B, SAS Tower, Medicity, Sector­38,
Gurgaon­122001, Phone:0124­301­6500 , Fax: 0124­423­4468 
CIN No: L74899DL1995PLC065388
Bill Of Supply
Summary of Invoice No....: C004277226/19­20/May/1
PAN Number......................:
Invoice Print Date .............: 08/05/2019
SAC NO..............................: 999316

Total for Patient : CHANDRAKANTA  SAXENA 60.00 18.00 0.00 42.00

Net Amount (Rs.) 31,387.00

Gross Amount ................: 48,818.00

Discount Amount ............: 9,618.00
Revenue Share ..............: 7,813.00
TDS (@ 10.00 %) ........:        782.00
Total Payable Amount ....: 32,169.00

Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204
Regd. Office:Dr. Lal PathLabs Ltd., Block E, Sector 18, Rohini, New Delhi­110085 ,Phone: 91­11­39885050 , Fax; 91­11­3040­3204