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OPERASI PERKHIDMATAN SOKONGAN


FAKULTI PERUBATAN VETERINAR
(HOSPITAL VETERINAR UNIVERSITI)

Kod Dokumen : OPR/FPV/BR013/SOE
SUMMARY OF EXPENSES

UNIVERSITY VETERINARY HOSPITAL(UVH), FPV, UPM Universiti Putra Malaysia 43400 Serdang Selangor
Tel : 603-8946 3954 / 3955 Fax : 603-8947 1973 Website : http://www.upm.edu.my/
 

Ref No. :

   
Date : 25-Oct-2014
 
I . CASE INFORMATION        
  Registration No. : Registration Date : 05-06-2013
  Next Appoinment Date : (DD-MM-YYYY) Visit Status :
  Owner's Name :
  I/C No. : Categori :
  Tel No. : Staff / Matriks No. :
  Address (Office) :
  Address (Home) :
  Patient No. : Animal ID :
  Species : B/Weight : A value is required.kg
  Service Fee : 0.00 (MYR)      
     
 
II . CHARGES      
             
  A . Consultation     Price (MYR)  
             
  Type : Small Animal/Avian - 1st Time / Animals     25.50  
  Others :     0.00  
        TOTAL :   25.50
             
  B . Transport (If Faculty vehicle is used)      
             
  0 KM (two way distance) MYR 0.40 /km TOTAL :   0.00
  Note :        
             
    A value is required.  
 
  C. DRUGS
Name
Quantity
Unit Price (MYR)
Total (MYR)
Heartgard 68mcg (blue)
1   box
62.00 / box 62.00
Troy Worm Ban Susp.
4.4   ml
0.50 / ml 2.20
Myonal 50mg Tab
5   tab
1.80 / tab 9.00
Metylcobal tab
7   tab
1.20 / tab 8.40
Advantage-cat Vial
1   tube
13.00 / tube 13.00
Cystaid Canine
4   caps
5.20 / caps 20.80
Tramadol Tab/ Acugesic Tab
1   tab
0.20 / tab 0.20
Tramadol inj./ Analab 50mg/ml Inj
1   amp
3.00 / amp 3.00
Vitamin B tab
5   tab
0.10 / tab 0.50
TOTAL                   119.10  
 
  D. CONSUMABLES
Name
Quantity
Unit Price (MYR)
Total (MYR)
Disp. Syringes 3ml
2   piece
0.35 / piece 0.70
Combi Stopper / red stopper
2   PIECE
0.70 / PIECE 1.40
Cerclage wire 18Gx10m
2   metre
15.50 / metre 31.00
Disp. Syringes 3ml
1   piece
0.35 / piece 0.35
TOTAL                   33.45  
 
  E. SURGERY
Name
Quantity
Unit Price (MYR)
Total (MYR)
5  
/ 75.00
5  
/ 75.00
TOTAL                   150.00  
 
  F. DIAGNOSTIC / OTHERS
Name
Quantity
Unit Price (MYR)
Total (MYR)
TOTAL                     0.00  
 
  G. NETT PRICE
Name
Quantity
Unit Price (MYR)
Total (MYR)
TOTAL                    0.00   
 
  H. NEW MEDICATION / PROCEDURE / OTHERS
Name
Quantity
Unit Price (MYR)
Total (MYR)
TOTAL                    0.00   
 
  I. LABORATORY FEES
Name
Quantity
Unit Price (MYR)
Total (MYR)
Clinical Pathology
1   sample
47.5 / sample 47.50
Parasitology
1   SAMPLE
65.00 / SAMPLE 65.00
TOTAL                    112.50   
 
  J. PET FOOD / PRESCRIPTION DIETS
Name
Quantity
Unit Price (MYR)
Total (MYR)
TOTAL                    0.00   
 

GRAND TOTAL (MYR)  17.50   

NO. SEMAKAN : 01
NO.ISU : 02
TARIKH KUATKUASA : 22/08/2011