10%approval Hospital Claims-March2013

SUMMARY SHEET FOR EACH HOSPITAL / NURSING HOME / DOCTOR
Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :9581431432 DR K SRINIVASULU REDDY 123647 SAFE CHILDREN HOSPITAL SAMHITHA MEDICALS MALLI KISHORE 99663342181 SS19392 & 31/01/2013 Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 02/6/2013 M/S SRI RAJESWARI MEDICAL AGENCIES
Product Name
CALSHINE P
Total Qty. Supplied

10
Additional Offer Given

1
Name of A.B.M. : Mr K G V R MOHAN
Name of R.B.M. :Mr Srininvas Sahu
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

FORWARDED BY : MODE OF DISPATCH : DATE OF RECEIPT : / / ENTRY DATE : ENTRY BY : DUMMY / OK / / ENTRY NO. : CHECKED BY : CHECKED DATE : / /
REMARK : FRS NO. : FRS DATE : / /

Product Name
CALSHINE P
Total Qty. Supplied

30

3
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Product Name
CALSHINE P
Total Qty. Supplied

17

1
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :9581431432 DR K V SRAVAN KUMAR 128042 AIMS HOSPITAL ABHIRAM MEDICALS SHABANA 08627-223399 SS18958 & 23/01/2013 Y VENKATESH E02474 MONTANA NELLORE NELLORE
M/S SRI RAJESWARI MEDICAL AGENCIE
Product Name
FERIS 50 FERIS DROPS
Total Qty. Supplied

10 10
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

FORWARDED BY : MODE OF DISPATCH : DATE OF RECEIPT : / / ENTRY DATE : ENTRY BY : DUMMY / OK / /
REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 02/6/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474
DR K V SRAVAN KUMAR AIMS HOSPITAL ABHIRAM MEDICALS SHABANA 08627-223399 SS18958 & 23/01/2013

1 1
M. :Mr Srininvas Sahu
M. :
ENTRY NO. : CHECKED BY : CHECKED DATE : / /
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :9581431432 DR K V SRAVAN KUMAR 128042 AIMS HOSPITAL ABHIRAM MEDICALS SHABANA 08627-223399 SS21454 & 06/03/2013 Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
CALSHINE D FERIS DROPS ACITRIX
Total Qty. Supplied

10 10 10
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 02/6/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474
DR K V SRAVAN KUMAR
00128042
AIMS HOSPITAL ABHIRAM MEDICALS SHABANA 08627-223399 SS21454 & 06/03/2013

1 1 1
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65806 MURALI HOSPITAL MURALI MEDICALS P.KONDAIAH 9533309233 SS18168 & 10/01/2013 9581431432 DR VEERAMMA Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
CALSHINE D
Total Qty. Supplied

50
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 02/6/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR VEERAMMA MURALI HOSPITAL MURALI MEDICALS P.KONDAIAH 9533309233 SS18168 & 10/01/2013

5
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :96311 ANANTH CHILDREN HOSPITAL SUPRABATH MEDICALS KONDAIAH 9490466962 SS18618 & 18/01/2013,SS18004 & 07/01/2013 9581431432 DR G MASTHANAIAH Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 02/6/2013 M/S SRI RAJESWARI MEDICAL AGENCIES
Product Name
BROXUM P CALSHINE P
Total Qty. Supplied

100 47

10 4
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :96311 ANANTH CHILDREN HOSPITAL SUPRABATH MEDICALS KONDAIAH 9490466962 SS20068 & 09/02/2013,SS20706 & 23/02/2013 9581431432 DR G MASTHANAIAH Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 02/6/2013 M/S SRI RAJESWARI MEDICAL AGENCIES
Product Name
BROXUM P BROXUM D FERIS DROPS CALSHINE P NIKOMOX CV
Total Qty. Supplied

30 30 30 10 60

3 3 3 1 6
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :96311 ANANTH CHILDREN HOSPITAL SUPRABATH MEDICALS KONDAIAH 9490466962 SS21518 & 07/03/2013 9581431432 DR G MASTHANAIAH Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 02/6/2013 M/S SRI RAJESWARI MEDICAL AGENCIES
Product Name
CALSHINE P ZEEGUT P
Total Qty. Supplied

50 50

5 5
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :9581431432 DR S ANDAL BHASKAR 65805 SRI SAI RAM INFERTILITY HOSPITAL SRI SAI RAM MEDICALS POORNIMA 0861-2328914 SS18725 & 21/01/2013 Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 02/6/2013 M/S SRI RAJESWARI MEDICAL AGENCIES
Product Name
CALSHINE 60K
Total Qty. Supplied

10

1
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :9581431432 DR S ANDAL BHASKAR 65805 SRI SAI RAM INFERTILITY HOSPITAL SRI SAI RAM MEDICALS POORNIMA 0861-2328914 SS19609 & 04/02/2013,SS20251 & 14/02/2013,SS20878 & 26/02/2013 Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 02/6/2013 M/S SRI RAJESWARI MEDICAL AGENCIES
Product Name
CALSHINE 60K
Total Qty. Supplied

30

3
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :9581431432 DR S ANDAL BHASKAR 65805 SRI SAI RAM INFERTILITY HOSPITAL SRI SAI RAM MEDICALS POORNIMA 0861-2328914 SS21193 & 04/03/2013,SS22462 & 23/03/2013 Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 02/6/2013 M/S SRI RAJESWARI MEDICAL AGENCIES
Product Name
CALSHINE 60K
Total Qty. Supplied

20

2
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65808 BHASKAR REDDY HOSPITAL V V MEDICALS VIJAY KUMAR/SANDEEP 9949413236 SS18601 & 18/01/2013 9581431432 DR B MADHULATHA Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
CALSHINE 60 K TABS ZEEGUT CAPS
Total Qty. Supplied

10 10
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 02/6/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR B MADHULATHA
HASKAR REDDY HOSPITAL V V MEDICALS 9949413236 SS18601 & 18/01/2013
VIJAY KUMAR/SANDEEP

1 1
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65808 BHASKAR REDDY HOSPITAL V V MEDICALS VIJAY KUMAR/SANDEEP 9949413236 9581431432 DR B MADHULATHA Y VENKATESH E02474 MONTANA NELLORE NELLORE
SS20447 & 18/02/2013,SS20279 & 15/02/2013
Product Name
ZEEGUT CAPS
Total Qty. Supplied

20
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 02/6/2013
HASKAR REDDY HOSPITAL V V MEDICALS 9949413236
VIJAY KUMAR/SANDEEP
& 18/02/2013,SS20279 & 15/02/2013

2
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65803 VIJAYA NURSING HOME SRI RANGA MEDICALS SRINIVAS 9030199532 SS22779 & 30/3/2013 9581431432 DR P VIJAYA LAXMI Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
CALSHINE D TABS FERIS SYP
Total Qty. Supplied

10 10
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 02/6/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR P VIJAYA LAXMI
VIJAYA NURSING HOME SRI RANGA MEDICALS SRINIVAS 9030199532 SS22779 & 30/3/2013

1 1
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :96294 ANKI REDDY CHILDREN HOSPITAL APARNA MEDICALS DR K ANKI REDDY 9440379115 SS20342 & 15/02/2013,SS20588 & 22/02/2013 9581431432 DR K ANKI REDDY Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 02/6/2013 M/S SRI RAJESWARI MEDICAL AGENCIES
Product Name
CALSHINE P FERIS 50
Total Qty. Supplied

20 10

2 1
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :96294 ANKI REDDY CHILDREN HOSPITAL APARNA MEDICALS DR K ANKI REDDY 9440379115 SS22048 & 15/03/2013 9581431432 DR K ANKI REDDY Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 02/6/2013 M/S SRI RAJESWARI MEDICAL AGENCIES
Product Name
ZEEGUT P FERIS 100
Total Qty. Supplied

50 10

5 1
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :96293 9581431432 DR M.THIRUMALESH
00096293
MONTANA NELLORE
Date : 04/05/2013
M/S MAHESWARI MEDICAL SYNDICATE NELLORE Y VENKATESH E02474
SAI THIRUMALESH CHILDRENS HOSPITAL RAJYALAKSHMI MEDICALS HAZARATH 9676022024 SR20268 & 14/03/2013
Product Name
ZEEGUT P
Total Qty. Supplied

54

5
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65865 NIZAM CHILDREN HOSPITAL SFS MEDICALS DR NIZAM 9440622300
SC21050 & 27/03/2013,SC20005&19/3/2013,SC20392 & 16/03/2013
MONTANA NELLORE
Date : 04/05/2013
M/S MAHESWARI MEDICAL SYNDICATE NELLORE Y VENKATESH E02474 9581431432 DR NIZAM
Product Name
CALSHINE 60K TABLETS CALSHINE P
Total Qty. Supplied

10

1
90
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65820 RAGHU RAM CHILDREN HOSPITAL VENKATA RAMESH MEDICALS RAMESH 9581431432 DR S RAGURAM Y VENKATESH E02474 MONTANA NELLORE NELLORE
M/S MAHESWARI MEDICAL SYNDICATE
SC201076 & 28/03/2013,SC19961 & 09/03/2013,SC20424 & 18/03/2013,SC20838 & 23/03/2013
Product Name
BROXUM D CALSHINE P
Total Qty. Supplied

10 50
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 04/05/2013
HESWARI MEDICAL SYNDICATE NELLORE E02474 DR S RAGURAM
U RAM CHILDREN HOSPITAL RAMESH
NKATA RAMESH MEDICALS
01076 & 28/03/2013,SC19961 & 3,SC20424 & 18/03/2013,SC20838 & 23/03/2013

1 5
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65812 SREE RAM CHILDREN HOSPITAL SRI VENKATA SAI NADHA MEDICALS DR S MANOHAR BABU 9849586871 9581431432 DR S MANOHAR BABU Y VENKATESH E02474 MONTANA NELLORE NELLORE
SR19573 & 02/03/2013,SR20398 & 16/3/2013
Product Name
CALSHINE P ZEEGUT Z
Total Qty. Supplied

50 100
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 04/05/2013
HESWARI MEDICAL SYNDICATE NELLORE E02474 DR S MANOHAR BABU RAM CHILDREN HOSPITAL DR S MANOHAR BABU 9849586871 & 02/03/2013,SR20398 & 16/3/2013
NKATA SAI NADHA MEDICALS

5 10
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65817 SRINIVAS CHILDREN HOSPITAL SRI NAGA MEDICALS NAGESH 0861-2329973 SC12562 & 6/11/2012 9581431432 DR B SRINIVAS RAO Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
CALSHINE P
Total Qty. Supplied

20
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 23/01/2013
HESWARI MEDICAL SYNDICATE NELLORE E02474 DR B SRINIVAS RAO
NIVAS CHILDREN HOSPITAL SRI NAGA MEDICALS NAGESH 0861-2329973 SC12562 & 6/11/2012

2
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :65808 BHASKAR REDDY HOSPITAL V V MEDICALS VIJAY KUMAR/SANDEEP 9949413236 9581431432 DR B MADHULATHA Y VENKATESH E02474 MONTANA NELLORE NELLORE
Supplied Invoice No. & Date of Stockiest :SS11985 & 3/10/2012,SS13200 & 18/10/2012,SS15051 & 17/11/2012,SS16306 & 10/12/201
Product Name
CALSHINE 60 K TABS ZEEGUT CAPS
Total Qty. Supplied

40 30
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 23/01/2013
HASKAR REDDY HOSPITAL V V MEDICALS 9949413236 & 17/11/2012,SS16306 & 10/12/2012,SS18498 & 17/1/2013,SS18601 & 18/1/2013
VIJAY KUMAR/SANDEEP

4 3
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :9581431432 DR K SOMANATH REDDY 65812 NIRUPA CHILDREN HOSPITAL NIRUPA MEDICALS DR K SOMANATH REDDY 9848094371 SS12814 & 13/10/2012 Y VENKATESH E02474 MONTANA M/S SRI RAJESWARI MEDICAL AGENCIES NELLORE NELLORE
Product Name
ZEEGUT Z SACHETS
Total Qty. Supplied

500
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
/ NURSING HOME / DOCTOR

Date : 23/01/2013
S SRI RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR K SOMANATH REDDY NIRUPA CHILDREN HOSPITAL NIRUPA MEDICALS DR K SOMANATH REDDY 9848094371 SS12814 & 13/10/2012

50
f R.B.M. :Mr Srininvas Sahu
R.B.M. :
Y
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65802 SRI RATNAM HOSPITAL SRAWYA MEDICALS PRATAP 9989005007 9581431432 DR P BHARATHI Y VENKATESH E02474 MONTANA NELLORE NELLORE
SS13312 & 20/10/2012,SS15219 & 20/12/2012
Product Name
FERIS 100 TABS
Total Qty. Supplied

20
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 23/01/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR P BHARATHI
SRI RATNAM HOSPITAL SRAWYA MEDICALS PRATAP 9989005007
& 20/10/2012,SS15219 & 20/12/2012

2
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65834 SUDHEER HOSPITAL SRI SUDHEER MEDICALS SUDHEER 0861-2336095 SC15533 & 28/12/2012 9581431432 DR J VANI Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
CALSHINE 60 K TABS
Total Qty. Supplied

10
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 23/01/2013
HESWARI MEDICAL SYNDICATE NELLORE E02474 DR J VANI SUDHEER HOSPITAL SUDHEER 0861-2336095 SC15533 & 28/12/2012
SRI SUDHEER MEDICALS

1
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :SS18618 & 18/1/2013 65820 RAGHU RAM CHILDREN HOSPITAL VENKATA RAMESH MEDICALS RAMESH 9581431432 DR S RAGURAM Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
BROXUM P CALSHINE P
Total Qty. Supplied

100 50
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 23/01/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR S RAGURAM
U RAM CHILDREN HOSPITAL RAMESH
NKATA RAMESH MEDICALS
SS18618 & 18/1/2013

10 5
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65817 SRINIVAS CHILDREN HOSPITAL SRI NAGA MEDICALS NAGESH 0861-2329973 SS16559 & 14/12/2012 9581431432 DR B SRINIVAS RAO Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
CALSHINE D
Total Qty. Supplied

10
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 23/01/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR B SRINIVAS RAO
NIVAS CHILDREN HOSPITAL SRI NAGA MEDICALS NAGESH 0861-2329973 SS16559 & 14/12/2012

1
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65803 VIJAYA NURSING HOME SRI RANGA MEDICALS SRINIVAS 9030199532 SS17140 & 24/12/2012 9581431432 DR P VIJAYA LAXMI Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
CALSHINE D TABS
Total Qty. Supplied

20
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 23/01/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR P VIJAYA LAXMI
VIJAYA NURSING HOME SRI RANGA MEDICALS SRINIVAS 9030199532 SS17140 & 24/12/2012

2
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65801 SRI DURGA HOSPITAL SAI DURGA MEDICALS SRAVANTHI 9885793133 SS13825 & 30/10/2012 9581431432 DR P YASODHARA Y VENKATESH E02474 MONTANA NELLORE NELLORE
Product Name
FERIS 100 TABS
Total Qty. Supplied

200
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 23/01/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR P YASODHARA SRI DURGA HOSPITAL SAI DURGA MEDICALS SRAVANTHI 9885793133 SS13825 & 30/10/2012

20
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :SS13615 & 30/10/2012 9581431432 DR S ANDAL BHASKAR 65805 SAI RAM MEDICALS ANDAL BHASKAR Y VENKATESH E02474 MONTANA NELLORE NELLORE
SRI ANDAL LAKSHMI FERTILITY CENTE
Product Name
CALSHINE 60K TABS
Total Qty. Supplied

10
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 23/01/2013
RAJESWARI MEDICAL AGENCIES NELLORE E02474 DR S ANDAL BHASKAR
AL LAKSHMI FERTILITY CENTER SAI RAM MEDICALS ANDAL BHASKAR
SS13615 & 30/10/2012

1
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :65845 DEEPTHI NURSING HOME SNEHA MEDICALS S LOKANADHAM 0861-2320802 S 1695 & 08/02/2013 9581431432 DR S SUMATHI Y VENKATESH E02474 NELLORE NELLORE MONTANA M/S ANKITHA ENTERPRISES
Product Name
RECONTREX TAB
Total Qty. Supplied

10
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY

REMARK : FRS NO. :
RSING HOME / DOCTOR

Date : 08/02/2013
S ANKITHA ENTERPRISES NELLORE E02474 DR S SUMATHI
EEPTHI NURSING HOME SNEHA MEDICALS S LOKANADHAM 0861-2320802 S 1695 & 08/02/2013

1
M. :
FRS DATE :

Division : Name of Stockiest :Station :Head Quarter :Name Of B. E. :Employee Code Of B. E. :Mobile No. Of B.E. :Name of Doctor :Doctor Code:Name of Hospital / Nursing Home :Name of Attached / In house Pharmacy :Name of Concern person of Hospital / Pharmacy :Contact No. of Concern Person of Hospital / Pharmacy :Supplied Invoice No. & Date of Stockiest :96294 ANKI REDDY CHILDREN HOSPITAL APARNA MEDICALS DR K ANKI REDDY 9440379115 SC20840 & 23/3/2013,SC19953 &09/3/2013,SC20840 & 23/03/2013 9581431432 DR K ANKI REDDY Y VENKATESH E02474 MONTANA NELLORE NELLORE Date : 04/05/2013 M/S MAHESWARI MEDICAL SYNDICATE
Product Name
VOMISAVE SPY ZEEGGUT P BROXUM P
Total Qty. Supplied

10 100 10

1 10 1
Sign of A.B.M. :
Sign Of R.B.M. :
FOR OFFICE USE ONLY


10%approval Hospital Claims-March2013

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10%approval Hospital Claims-March2013

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SUMMARY SHEET FOR EACH HOSPITAL / NURSING HOME / DOCTOR

Total Qty. Supplied

Additional Offer Given

Name of A.B.M. : Mr K G V R MOHAN

Name of R.B.M. :Mr Srininvas Sahu

FOR OFFICE USE ONLY

REMARK : FRS NO. : FRS DATE : / /

SUMMARY SHEET FOR EACH HOSPITAL / NURSING HOME / DOCTOR

Total Qty. Supplied

Additional Offer Given

Name of A.B.M. : Mr K G V R MOHAN

Name of R.B.M. :Mr Srininvas Sahu

FOR OFFICE USE ONLY

REMARK : FRS NO. : FRS DATE : / /

SUMMARY SHEET FOR EACH HOSPITAL / NURSING HOME / DOCTOR

Total Qty. Supplied

Additional Offer Given

Name of A.B.M. : Mr K G V R MOHAN

Name of R.B.M. :Mr Srininvas Sahu

FOR OFFICE USE ONLY

REMARK : FRS NO. : FRS DATE : / /

SUMMARY SHEET FOR EACH HOSPITAL / NURSING HOME / DOCTOR

M/S SRI RAJESWARI MEDICAL AGENCIE

Total Qty. Supplied

Name of A.B.M. : Mr K G V R MOHAN

Name of R.B.M. :Mr Srininvas Sahu

FOR OFFICE USE ONLY

REMARK : FRS NO. :

RSING HOME / DOCTOR

RAJESWARI MEDICAL AGENCIES NELLORE E02474

Additional Offer Given

M. :Mr Srininvas Sahu

ENTRY NO. : CHECKED BY : CHECKED DATE : / /

SUMMARY SHEET FOR EACH HOSPITAL / NURSING HOME / DOCTOR

M/S SRI RAJESWARI MEDICAL AGENCIE

Total Qty. Supplied

Name of A.B.M. : Mr K G V R MOHAN

Name of R.B.M. :Mr Srininvas Sahu

FOR OFFICE USE ONLY

REMARK : FRS NO. :

RSING HOME / DOCTOR

RAJESWARI MEDICAL AGENCIES NELLORE E02474

AIMS HOSPITAL ABHIRAM MEDICALS SHABANA 08627-223399 SS21454 & 06/03/2013

Additional Offer Given

M. :Mr Srininvas Sahu

ENTRY NO. : CHECKED BY : CHECKED DATE : / /

SUMMARY SHEET FOR EACH HOSPITAL / NURSING HOME / DOCTOR

M/S SRI RAJESWARI MEDICAL AGENCIE

Total Qty. Supplied

Name of A.B.M. : Mr K G V R MOHAN

Name of R.B.M. :Mr Srininvas Sahu

FOR OFFICE USE ONLY

REMARK : FRS NO. :

RSING HOME / DOCTOR

Additional Offer Given

M. :Mr Srininvas Sahu

ENTRY NO. : CHECKED BY : CHECKED DATE : / /

SUMMARY SHEET FOR EACH HOSPITAL / NURSING HOME / DOCTOR

Total Qty. Supplied

Additional Offer Given

Name of A.B.M. : Mr K G V R MOHAN

Name of R.B.M. :Mr Srininvas Sahu

FOR OFFICE USE ONLY