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12/27/2017 Dhims 2

Monthly Facility IGF Revenue Form

Revenue Collected (cash & Corporate (Defered


Item Budget NHIS Total Variance
carry) Payment)

Medicines &
0 0
Pharmaceuticals

Surgical 0 0

Medical 0 0

Investigation 0 0

OPD 0 0

OBGY 0 0

Dental 0 0

Peadiatrics 0 0

Ear, Nose &


0 0
Throat

Eye Care 0 0

Feeding (DHO) 0 0

Mortuary 0 0

Ambulance Fees 0 0

Opthalmology 0 0

Physiotherapy 0 0

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12/27/2017 Dhims 2
Examination
0 0
Fees

Registration
0 0
Fees

Dialysis 0 0

Testing Fees 0 0

Others (Specify) 0 0

Anaesthetics

Blood bank

C.T. Scan

Cardiology

Clinical
Treatment

Diagnostic Centre

Dressing and
Injections

Family Planning

Optometry

Plastic Surgery

Radiotherapy

Tender
Documents

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Sub-Total
0 0 0 0 0 0
Services

Grand Total 0 0 0 0 0 0

Complete Incomplete | Run validation

Completed by: PAAPAK at: 2017-12-14 See details

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