Jenus Ana

Room Allotment Details

Occupied

Allotment ID: RA-001  |  Room: 301  |  Patient: John Smith

Patient Information

Name

John Smith

Contact

+1 (555) 123-4567

Patient ID

P-1001

Email

demo@gmail.com

Age

45 years

Gender

Male

Address

123 Main St, Anytown, CA 12345

Room Information

Room Number

301

Daily Rate

$350/day

Room Type

Private

Floor

3rd Floor

Department

Cardiology

Facilities

Private Bathroom TV WiFi Adjustable Bed Nurse Call System Oxygen Supply

Allotment Details

Allotment Date

2025-04-15

Allotment Time

10:30 AM

Expected Discharge

2025-04-23

Actual Discharge

Not discharged yet

Attending Doctor

Dr. Emily Chen

Doctor ID

D-2001

Admission Reason

Chest pain and shortness of breath

Diagnosis

Acute Myocardial Infarction

Billing Information

Billing Status

Insurance Verified

Daily Room Rate

$350.00

Insurance Provider

Blue Cross Blue Shield

Policy Number

BCBS-12345678

Item Rate Days Amount
Room Charges (Private) $350/day 5 $1750.00
Nursing Care $150/day 5 $750.00
Medications $320.00
Laboratory Tests $450.00
Total Estimated Charges ≈ $3270.00
Condition Date Diagnosis Treatment Provided Doctor Notes
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