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 GIMSR - Pharmacy Receipts Online Challan
 Receipt Details     
1 Pharmacy Receipts *
MemberID *  
3 Head Codes 101.Pharmacy Receipts  
    102.OT Disposables  
      Description
4 Total Amount * * Payment Mode
5 Ref.No. Remarks1
6 Remitted By * *   Remarks2 *  
7 DD No   DD Amount
8 DD Bank Name   DD Date(dd-mon-yyyy)
  Select Bank :    
 
 Union Bank Of India    
 
     
 
Hospital Receipts