Baby Medics - New Patient Patient IntakeΔLast VisitPrevious TimeDateCurrent TimeRefundReceipt Type-Receipt Type-InvoiceRefundAdmissionDischargePrevious InvoicePatient NameFather/Husband NameDate Of BirthEmailMobileCity- Select City-LahoreRawalpindiIslamabadArea/Address- Select Area-Airport Housing SocietyAqsa TownBahria TownCBR TownChaklalaChandni ChowkDHADoctors TownFazaia ColonyFazal TownGhauri TownGulbergGulraizGulzar e QuaidJinnah GardensJudicial ColonyKhanna PulKorang TownLohi BherMedia TownModel TownNaval AnchorageNew Lala ZarPakistan TownPolice FoundationPWDRaja BazarRiver GardensScheme 3Shaheen TownSoan GardensOtherOther AreaDoctor- Select Doctor -Dr Saad HameedDr Salman Ahmad BajwaNoor Us ShabaDr Anwar HussainDr Aina TariqDr Muizza AbbasDr M Bilal AbidDr Omar WarraichDr Abdul BasitDr Ahmad NaseerDr Syed Ali Hasan RizviDr Asma BasheerDr Hijab ShaheenDr Attiya ElahiDr Kokab NaeemDr Anam ZehraDr Mujahid SattarDr Husnain AkramDr Zahra MushtaqDr Najwa AfzalDr Hassan SalimMiss Naila AmirDr Sibt E HassanDr Sidra ShahidLt. Col. (R) Dr. Rizwan QureshiDr Muhammad KaleemDr Madiha InshaDr Faria AliDr Saba JavedDr Zarmina KhanMinahel KhanDr Ayesha Habib KhanDr Sania BatoolDr Kiran IqbalDr Kashaf TauseefDr NabeelDr Bashir Ur RahmanDr Ayesha AhmadDr Sidra ShahidDr Saman TauseefDr Yasir IqbalDr Danish MaqboolDr Abdalmalek IsmailDr Mumtaz AkhtarDr Qurat ul AinDr Hidayat ul HaqNursing ProcedureDr Samreen NisarDr Asim IkramDr Misbah ud DinDr Faryal KousarDr Amna RiazDr Tayyaba BashirCheckup Type- Select Checkup Type-GynaeCTGC- section without medsNormal delivery without medsUltrasoundObstetrtic USGEndometrial BiopsyERPCImplanon insertionImplanon RemovalJadelle Implant InsertionJadelle Implant RemovalIUCD InsertionIUCD RemovalHymen RepairVaginal Repairing/TighteningIUIBartholine CystD & CStitch RemovalTreatment/ProceduresCERVICAL CERCLAGE1. Obstetric Consultation With Scan2. Obstetric Consultation With ScanCheckup Type- Select Checkup Type-Pediatric ConsultationDiabetic FootVaccinationFollow UpSick Baby CheckupNutrition and GrowthNebulizationUltrasoundEmergencyTreatment/ProceduresLaboratoryCheckup Type- Select Checkup Type-Medical SpecialistClinical PsychologistFamily PhysicianChild Psychology ConsultationMedicineEmergencyUltrasoundVaccinationDiabetic FootTreatment/ProceduresMedical Specialist ConsultationCheckup Type- Select Checkup Type-CircumcisionGeneral SurgeonCircumcision DiscountedHair TransplantStitch RemovalEmergencyDiabetic FootSurgeryTreatment/ProceduresSurgical ConsultationMole ExcisionHydrafacialGeneral SurgeonOrthopedic ConsultationPOP CastPOP RemovalPediatric SurgeonCheckup Type- Select Checkup Type-Peds MOGyne MOGeneral PhysicianEmergencyVaccinationTreatment/ProceduresCheckup Type- Select Checkup Type-Physiotherapy Consultation & SessionConsultation & SessionConsultationSessionPhysiotherapy Home SessionPhysiotherapy SessionFamily PhysicianSpeech Therapist Consultation & SessionPhysiotherapy ConsultationEmergencyTreatment/ProceduresNutrition ConsultationPhysiotherapy package (7 Sessions) Non-refundablePhysiotherapy package (15 Sessions) Non-refundablePhysiotherapy package (20 Sessions) Non-refundableCheckup Type- Select Checkup Type-Abdomen UltrasoundPelvis UltrasoundKUB UltrasoundProstate UltrasoundScrotum UltrasoundUltrasound Liver & Biliary Tree including Gall BladderThyroid UltrasoundCarotid Artery UltrasoundUltrasound Deep Vein Thrombosis( DVT)Fetal Well Being UltrasoundAnomaly Scan UltrasoundUltrasound Abdomen and PelvisInguinal/Scrotal UltrasoundJoint UltrasoundCheckup Type- Select Checkup Type-Dermatology ConsultationHydrafacialPRP TherapyLaser Hair RemovalChemical PeelsSkin WhiteningMinor CauteryAttendant NameRelation- Select Relation -FatherMotherUncleAuntGrandfatherGrandmotherMyselfCNICFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesFees/ChargesNurse- Select Nurse-SaddamMariaAtifSaleemKinzaPayment Method- Payment Method -CashCardInternet BankingJazzCashOther Procedures- Procedures -YesNoIV Canula insertion (without supplies) IV Canula insertion (without supplies)Suppository Insertion Suppository InsertionBSR BSRMinor Dressing - Nurse Minor Dressing (Nurse)Foley Catheter Insertion (Without Supplies) Foley Catheter Insertion (Without Supplies)PRP PRP (2 Sessions)Vaccination Charges Vaccination ChargesOxygen Charges Oxygen ChargesIM Injection (Fee) IM Injection (Fee)Major Dressing Major DressingRectal Enema Rectal EnemaRetain Charges SR Retain Charges SRNebulization (Without Medicine) Nebulization (Without Medicine)Stomach Wash Stomach Wash (Without Supplies)Stitches StitchesDoctor Dressing / Steri Strip Doctor Dressing / Steri StripIV Injection (Fee) IV Injection (Fee)Retain Charges ER Retain Charges ERElectrocautery ElectrocauteryI & D (Small) I & D SmallRetain Charges VIP Room Retain Charges VIP RoomDental X Ray Dental X RayIV CanulaIM InjectionsIV InjectionsSuppository InsertionRectal EnemaRetain Charges ERBSRRetain Charges SRMinor Dressing By NurseMajor DressingDoctor Dressing / Steri StripNumber of StitchesElectrocauteryNumber of FCINumber of Nebulization (Without Medicine)Ear Wax RemovalStomach WashStomach WashVaccination ChargesRetain Charges VIPDental X RayOxygenIV Canula PriceIM Injection PriceIV Injection PriceSuppository Insertion PriceRectal Enema PriceRetain Charges ERBSR ChargesRetain Charges SRMinor Dressing (Nurse) ChargesMajor Dressing (Nurse) ChargesDoctor Dressing / Steri StripCharges per stitchElectrocautery ChargesFoley Catheter Insertion (Without Supplies)Nebulization (Without Medicine)PRPStomach WashI & D (Small)Vaccination ChargesRetain Charges VIPDental X RayOxygenIV Canula AmountIM Injection AmountIV Injection AmountSuppository Insertion AmountRectal Enema AmountRetain Charges ERBSR ChargesRetain Charges SRMinor Dressing (Nurse) ChargesMajor DressingDoctor Dressing / Steri StripMajor Dressing (Doctor) ChargesElectrocautery ChargesFCI ChargesNebulization (Without Medicine) ChargesPRPStomach Wash I & D (Small)Vaccination ChargesRetain Charges VIPDental X RayOxygenTotalDiscountNet TotalDisposablesDisposablesRsGross TotalGross TotalRsDoctor's 50%Doctor's 50%RsDoctor's 65%Doctor's 65%RsDoctor's 60%Doctor's 60%RsDoctor's 70%Doctor's 70%RsDoctor's 72.5%Doctor's 72.5%RsDoctor's 80%Doctor's 80%RsSubmit
