Health Information Management Services (HIMS)
Medical Report Section

Payment Receipt / Tax Invoice

Tel: (65) 6222 33 22
Fax: (65) 6224 92 21
Singapore General Hospital
Outram Road Singapore 169608
www.sgh.com.sg
Reg No: 198703907Z
GST Reg No: M02-0088822-7

Payee's Name:

Date:

Address:

Payment Ref:

Requestor:

Currency:

Patient:

Payment Mode:

NRIC/FIN/HRN:

S/N	Request Number	Description	Unit Price SGD	Total Price SGD
Delivery Charge
Sub-Total
%GST
Total Amount Payable
Amount Received
Balance Amount