{% extends 'base_print.html.twig' %}

{% block title %}Service Book{% endblock %}

{% block styles %}
	<style>
		h1 { text-align: center; border-bottom: 1px solid #000; margin: 0; }
		h2 { page-break-before: always; }
		.details th { text-align: left; }
		table {
			border-collapse: collapse;
			broder:  1px solid #000;
			width: 100%;
			max-width: 100%;
			page-break-inside: avoid;
		}
		th, td { border: 1px solid #000; padding: 5px; }
		ul{
			list-style-type: none;
		}
	</style>
{% endblock %}

{% block content %}
	<h1>Details Receipt</h1>
		<div style="font-size: 16px;">
			<span style=" margin-left: 6px; font-size: 20px; margin-left: 377px;">
				<strong style=" margin-left: 6px; font-size: 20px; margin-left: 377px;"> Civil Hospital Ahmedabad</strong></span>
		</div>

		<div class="row"">
			<div style="float: left; width: 50%;">
				<p style="color: #7e8d9f;font-size: 13px; padding: 6px;
				margin-left: 4px;"><span style="font-weight: 600;">Patient Details :</span>
					</p>
			</div>
			<div style="float: right; width: 50%;">
				<p style="color: #7e8d9f;font-size: 13px; padding: 6px;
					float: right; margin-right: 17px;"><span style="font-weight: 600;">MRD NO :</span> 11203</p>
			</div>
		</div>

		<div class="row" style="padding: 102px;">
			<div class="col-sm-4" style=" float: left; width: 33%;">
				<ul class="list-unstyled">
					<li class="text-muted">
						<span style="color:#53585b ; font-weight: 400;">Name :</span>
						<span style="color:#74788d ; ">John Lorem</span>
					</li>
					<li class="text-muted">
						<span style="color:#53585b ; font-weight: 400;">Address:</span>
						<span style="color:#74788d ;">Street,
							City, State, Country</span>
					</li>
					<li class="text-muted">
						<span
							class="fw-bold">
							<span style="color:#53585b ; font-weight: 400;">Date Of visit:</span>
						</span style="color:#74788d ;">Jun 23,2021</li>
					<li class="text-muted">
						<span
							class="fw-bold">
							<span style="color:#53585b ; font-weight: 400;">Discharge:</span>
						</span style="color:#74788d ;">Jun 23,2021</li>
				</ul>
			</div>
			<div class="col-sm-4" style=" float: left; width: 33%;">
                                <ul class="list-unstyled">
                                    <li class="text-muted">
                                        <span style="color:#53585b ; font-weight: 400;">Age:</span>
                                        <span style="color:#74788d ;">27</span>
                                    </li>
                                    <li class="text-muted">
                                        <span style="color:#53585b ; font-weight: 400;">Contact No:</span>
                                        <span style="color:#74788d ;">
                                            123-456-789</span>
                                    </li>
                                    <li class="text-muted">
                                        <span style="color:#53585b ; font-weight: 400;">Net payment:</span>
                                        <span style="color:#74788d ;">27,000</span>
                                    </li>
                                </ul>
			</div>
			<div class="col-sm-4" style=" float: left; width: 33%;">
				<ul class="list-unstyled">
					<li class="text-muted">
						<span style="color:#53585b ; font-weight: 400;">M/F:</span>
						<span style="color:#74788d ;">Male</span>
					</li>
					<li class="text-muted">
						<span style="color:#53585b ; font-weight: 400;">Email ID:</span>
						<span style="color:#74788d ;"><i
								class="fas fa-email"></i>
							hospital@gmail.com</span>
					</li>
					<li class="text-muted">
						<span style="color:#53585b ; font-weight: 400;">Cash/card/Gpay/Net banking:</span>
						<span style="color:#74788d ;">Net banking</span>
					</li>
				</ul>
			</div>
		</div>
<br>
	<table >
		<thead>
			<tr>
				<th scope="col">#</th>
				<th scope="col">Departments</th>
				<th scope="col">Charges</th>
				<th scope="col">Departments</th>
				<th scope="col">Charges</th>
			</tr>
		</thead>
		<tbody>
			<tr>
				<th>01</th>
				<td>IPD</td>
				<td>4,000</td>
				<td>Pharmacy</td>
				<td>1,000</td>
			</tr>
			<tr>
				<th>02</th>
				<td>Admission</td>
				<td>1,200</td>
				<td>Ward</td>
				<td>9,010</td>
			</tr>
			<tr>
				<th>03</th>
				<td>Lab</td>
				<td>6,000</td>
				<td>OT</td>
				<td>10,000</td>
			</tr>
			<tr>
				<th>04</th>
				<td>Radiology</td>
				<td>1,710</td>
				<td>Anaesthesia</td>
				<td>9,100</td>
			</tr>
			<tr>
				<th>05</th>
				<td>Blood Bank</td>
				<td>4,000</td>
				<td>Delivery</td>
				<td>2,000</td>
			</tr>
			<tr>
				<th>06</th>
				<td>Food</td>
				<td>3,300</td>
				<td>Other Service</td>
				<td>2,910</td>
			</tr>
			<tr>
				<th>07</th>
				<td>Laundry</td>
				<td>1,000</td>
				<td>Surgery</td>
				<td>9,200</td>
			</tr>
		</tbody>
	</table>

	<div class="row" style="padding: 2px;">
		<div class="col-sm-4" style=" float: left; width: 33%;">
			<ul>
				<li><span>Advance paid :</span> 1110</li>
				<li class="text-muted ms-3 mt-2"><span> Net
						Expenditure :</span> 111</li>
				<li class="text-muted ms-3 mt-2"><span>
						Payble/refundable :</span> 111</li>
			</ul>
		</div>
		<div class="col-sm-4" style=" float: left; width: 33%;">
			<p style="text-align: center;"><span
					class="text-black me-3"> Total Payment : </span><span
					style="font-size: 20px;"> 1221</span></p>
			<ul style="text-align: center;">
				<li><span>Insurance
						Claim : </span> 1110</li>
				<li class="text-muted ms-3 mt-2"><span>Discount :
					</span>(15%)</li>
			</ul>
			<p style="text-align: center;"><span
					class="text-black me-3"> GST : </span><span
					style="font-size: 15px;">(18%)</span></p>
		</div>
		<div class="col-sm-4" style=" float: left; width: 33%;">
			<p style="text-align: right;"><span
					class="text-black me-3"> Mode Payment : </span><span
					style="font-size: 20px;"> 1221</span></p>
			<ul style="text-align: right;">
				<li><span>Company : </span> 1110</li>
				<li class="text-muted ms-3 mt-2"><span>After
						Discount :</span>(08%)</li>
			</ul>
			<p style="text-align: right;"><span
					class="text-black me-3"> Total :</span><span
					style="font-size: 15px;"> 12,021</span></p>
		</div>
	</div>

{% endblock %}