{{headerDetail.CustomerName}}

{{headerDetail.Address}}

Ph No: {{headerDetail.Tel}}

{{headerDetail.CustomerRegLabel}}

Provisional Cancel Receipt

Hospital No: {{ProvisionalDetails.PatientCode}}

Date: {{CurrentDate| nepaliDate}}

Patient Name:{{ProvisionalDetails.PatientName}}

Age/Sex : {{ProvisionalDetails.Age}}/{{ProvisionalDetails.Gender}}

Address: {{ProvisionalDetails.Address}} , {{ProvisionalDetails.CountrySubdivisionName}}

Contact: {{ProvisionalDetails.PhoneNumber}}

Type: {{ProvisionalDetails.SchemeName}}

Policy/MemberNo: {{PolicyNo}}

SN. Receipt No Ref. Receipt No Date Particular(s) Unit Price Amount
{{1}} PRC/{{ ProvisionalDetails.CancellationReceiptNo}} PR/{{ ProvisionalDetails.ReferenceProvisionalReceiptNo}} {{ProvisionalDetails.CreatedOn | DanpheDateTime:'format':'YYYY-MM-DD'}} {{ProvisionalDetails.ItemName}} ({{ProvisionalDetails.AssignedToDrName}}) {{ProvisionalDetails.CancelledQty}} {{ProvisionalDetails.Price | number : "1.2-2"}} {{ProvisionalDetails.CancelledQty * ProvisionalDetails.Price | number : "1.2-2"}}

In Words : {{ProvisionalDetails.CancelledTotalAmount | NumberInWords}} Only

SubTotal: {{ProvisionalDetails.CancelledSubtotal | number : "1.2-2"}}

Discount: {{ProvisionalDetails.CancelledDiscountAmount | number : "1.2-2"}}

Total Amount: {{ProvisionalDetails.CancelledTotalAmount | number : "1.2-2"}}

User: {{ProvisionalDetails.User}}

{{billCancellationReceiptFooter.EnglishText}}
{{billCancellationReceiptFooter.NepaliText}}