🏥 Hospital Details
👤 Patient Details
💰 Payment Details
📋 Services (Optional)
CITY CARE HOSPITAL
12, MG Road, Bangalore - 560001
Ph: +91 80 4567 8901
MR001
Receipt
25 Aug 2026
Receipt
25 Aug 2026
Amount Received
₹5,000.00
Rupees Five Thousand Only
Received with thanks from
Patient Name
Age / Gender
32Y / Male
UHID
UH2026-001
Towards
Consultation & Lab Tests
Payment Mode
Cash
Services
Total₹2,000
REVENUE
STAMP
STAMP
Revenue stamp for amount > ₹5000
PAID
✓
✓
For City Care Hospital
Authorized Signatory
Patient / Guardian