J M Diagnostic

SAKSHI YOGESH DAUNDKAR

JM-20260828121523 · 2026-08-28 · 11:58

Bill Sent
PCPNDT · Form F — 2 separate prints
Pre-procedure (Pages 2 & 3)
Declaration + Disclaimer — patient signs this on arrival, before the USG is done.
Print Declaration + Disclaimer
Post-procedure (Page 1 only)
Ready
USG report captured — statutory Form F Page 1 is ready for the register file.
Print Form F Page 1
Tests
1Twins Late Tiffa scanUSG₹4,500
23 D ImageUSG₹1,000
3TVS 500 USGUSG₹500
Clinical
LMP
2026-04-17
Known case of
Seen
Advice
Staff
Vaishnavi
Account
Cash
Next Appointment
Reason
Next ANC
Next Consultation
Category Charges
Routine
₹0
Special
₹0
USG
₹6,000
X-Ray
₹0
ECG
₹0
Doppler
₹0
Cardiac
₹0
Consultation
₹0
HSG
₹0