{{headerDetail.CustomerName}}

{{headerDetail.Address}}

Ph No: {{headerDetail.Tel}}

{{headerDetail.CustomerRegLabel}}

Provisional Slip

Hospital No: {{ProvisionalSlipDetails.PatientCode}}

Date: {{CurrentDate| nepaliDate}}

Patient Name:{{ProvisionalSlipDetails.PatientName}}

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

Address: {{ProvisionalSlipDetails.Address}} , {{ProvisionalSlipDetails.CountrySubdivisionName}}

Contact: {{ProvisionalSlipDetails.PhoneNumber}}

Type: {{SchemeName}}

Policy/MemberNo: {{PolicyNo}}

SN. Receipt No Date Particular(s) Unit Price Amount
{{i+1}} PR/{{ row.ProvisionalReceiptNo}} {{row.CreatedOn | DanpheDateTime:'format':'YYYY-MM-DD'}} {{row.ItemName}} ({{row.AssignedToDrName}}) {{row.Quantity}} {{row.Price | number : "1.2-2"}} {{row.Quantity * row.Price | number : "1.2-2"}}

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

SubTotal: {{model.SubTotal | number : "1.2-2"}}

Discount: {{model.TotalDiscount | number : "1.2-2"}}

{{taxLabel}}{{model.TaxAmount | number : "1.2-2"}}

Total Amount: {{model.TotalAmount | number : "1.2-2"}}

CoPay: {{model.CoPayAmount | number :"1.2-2"}}

User: {{ProvisionalSlipDetails.BillingUser}}

{{provSlipFooterParam.EnglishText}}
{{provSlipFooterParam.NepaliText}}