test Create invoice Invoice date GEN ID Eyes AutoID Eyes ID ENT AutoID ENT ID First name * Last name * Patient ID * Date of birth * Address * Sex * MaleFemale Age calculator (days) DOB checker *Date of birth must be completed Create invoice for Department * GeneralEyesENT New or follow up * New Follow up Invoice for Outpatient services Surgery Date of invoice Today Roll to tomorrow Invoice ID General invoice Consultation Yes Blood tests Yes X-rays Cone beam CT Yes Outpatient procedues Physiotherapy session Physiotherapy splinting / casting (simple) Physiotherapy splinting / casting (complex) Minor procedure (under sedation / LA) Nursing procedure Surgery Category Set General Price per x-ray Recommended consultation Recommended blood tests Recommended physio session Recommended physio casting / splinting (simple) Recommended physio casting / splinting (complex) Recommended minor procedure Recommended nursing procedure Recommended gen cat 1 Recommended gen cat 2 Recommended gen cat 3 Recommended gen cat 4 Recommended gen cat 5 Recommended gen cat 0 Recommended conebeam Recommended x-ray ENT Invoice Select diagnosis for new patient: Common ear conditions Wax CSOM/retraction pocket Otitis media Otitis externa Hearing loss/tinnitus Cholesteatoma Common neck and throat conditions Tonsillitis/pharyngitis GERD Laryngeal pathology Salivary gland pathology Thyroid pathology Sleep disordered breathing Common nose conditions Allergic rhinitis Sinusitis/Rhinitis/polyps Septal deviation Other diagnoses Malignant tumour Benign tumour Preauricular sinus Foreign body Lacrimal duct obstruction Other Set ENT Set Surgery Select fees: Consultation Yes Blood tests Yes X-rays Cone beam CT Yes Outpatient services Tympanometry only Audiometry Hearing aid moulding Hearing aid fitting Flexible nasendocopy Outpatient procedure Surgery Recommended consultation Recommended consultation Blood tests (ENT) X-rays (ENT) Outpatient procedure cost Tympanometry cost Audiometry cost Cone beam CT cost Flexible nasendoscopy cost Hearing aid moulding cost Hearing aid fitting cost Recommended ENT xrays Recommended ENT Surgery Eyes Invoice Consultation Yes Blood tests Yes X-rays Eye Investigations B-Scan Fundus photos OCT Refraction assessment Outpatient services Glasses (cutting and frame) Minor procedure Eye laser treatment - unilateral Eye laser treatment - bilateral Set eyes Set eyes surgery Surgery Recommended eye Surgery Recommended consultation Recommended B-scan Recommended Fundus photo Recommended OCT photo Recommended refraction assessment Recommended glasses Recommended minor procedure Recommended laser - unilateral Recommended laser - bilateral Recommended blood tests Recommended per xray Recommended xrays totay Recommended donation Total recommended donation (USD) $ Total recommended donation (Riel) KHR No fee checker User Pin for Guest * Pin Sin Valid pin Create invoice If you are human, leave this field blank.