{{headerDetail.hospitalName}}

{{headerDetail.address}}

{{ headerDetail.tel}}

{{ headerDetail.DDA}}

{{GeneralFieldLabel.PANNo}} : {{headerDetail.PANno}}

PHARMACY UNITS

Provisional Return

Receipt No : {{ProvisionalInvoiceReturn.CancellationReceiptNo}}

Hospital No : {{ProvisionalInvoiceReturn.PatientInfo.PatientCode}}

Return Date: {{ProvisionalInvoiceReturn.ReturnDate | DanpheDateTime:'format':'YYYY-MM-DD'}}

Patient's Name: {{ProvisionalInvoiceReturn.PatientInfo.ShortName}}

{{ProvisionalInvoiceReturn.ReturnDate | nepaliDate }}

Address: {{ProvisionalInvoiceReturn.PatientInfo.Address}}, {{ProvisionalInvoiceReturn.PatientInfo.CountrySubDivisionName}}

Age/Sex :{{ProvisionalInvoiceReturn.PatientInfo.DateOfBirth | DanpheDateTime:'age' }}/{{ProvisionalInvoiceReturn.PatientInfo.Gender}}

Provider's Name: {{ProvisionalInvoiceReturn.ProviderName}}

{{GeneralFieldLabel.NMCNo}}:{{ProvisionalInvoiceReturn.ProviderNMCNumber}}

ClaimCode: {{ProvisionalInvoiceReturn.ClaimCode}}

PolicyNo: {{ProvisionalInvoiceReturn.PolicyNo}}

Contact No: {{ProvisionalInvoiceReturn.PatientInfo.PhoneNumber}}

SN. Particular(s) Qty Expiry Batch Rack No. Rate Amount
{{i+1}} {{row.ItemDisplayName}} {{row.Quantity}} {{row.ExpiryDate | date: 'dd MMM yyy'}} {{row.BatchNo}} {{row.RackNo}} {{row.SalePrice | number: "1.2-4"}} {{row.SubTotal | number: "1.2-4"}}

In Words :{{ProvisionalInvoiceReturn.TotalAmount | NumberInWords}} Only

SubTotal:

Discount:

VAT:

CoPay Cash Amount:

CoPay Credit Amount:

Total Amount:

{{ProvisionalInvoiceReturn.SubTotal | number: "1.2-4"}}

{{ProvisionalInvoiceReturn.DiscountAmount |number: "1.2-4"}}

{{ProvisionalInvoiceReturn.VATAmount | number: "1.2-4"}}

{{ProvisionalInvoiceReturn.CoPaymentCashAmount | number: "1.2-4"}}

{{ProvisionalInvoiceReturn.CoPaymentCreditAmount | number: "1.2-4"}}

{{coreService.currencyUnit}}{{ProvisionalInvoiceReturn.TotalAmount | number: "1.2-4"}}

User: {{ProvisionalInvoiceReturn.UserName}}

Time: {{ProvisionalInvoiceReturn.ReturnDate | DanpheDateTime:'format':'HH:mm'}}

{{englishText}}

{{nepaliText}}