Cancer Research Hospital, a charitable healthcare institution, provides medical services at subsidized rates. During the audit for the financial year 2025-26, the auditor observed the following: Bills had not been issued

The special steps or audit procedures an auditor should apply while auditing the transactions of hospital include the following: Register of Patients: Vouch the Register of patients with copies of bills issued to them. Verify bills for a selected period with the patients' attendance record to see that the bills have been correctly prepared. Also see that bills have been issued to all patients from whom an amount was recoverable according to the rules of the hospital. Collection of Cash: Check cash collections as entered in the Cash Book with the receipts, counterfoils and other evidence. E.g. copies of patients' bills, counterfoils of dividend and other interest warrants, copies of rent bills, etc. Income from Investments, Rent, etc.: See with reference to the property and Investment Register that all income that should have been received by way of rent on properties, dividends, and interest on securities have been collected. Legacies and Donations: Ascertain those legacies and donations received for a specific purpose have been applied in the manner agreed upon. Reconciliation of subscriptions: Trace all collections of subscription and donations from the Cash Book to the respective Registers. Reconcile the total subscriptions due (as shown by the Subscription Register and the amount collected and that still outstanding). Authorization and sanctions: Vouch all purchases and expenses and verify that the capital expenditure was incurred only with the prior sanction of the trustees or the Managing Committee and that appointments and increments to staff have been duly authorized. Grants and TDS: Verify that grants, if any, received from Government or local authority has been duly accounted for. Also, that refund in respect of taxes deducted at source has been claimed. Budgets: Compare the totals of various items of expenditure and income with the amount budgeted for them and report to the Trustees or the Managing Committee, significant variations which have taken place. Internal Check: Examine the internal check as regards the receipt and issue of stores; medicines, linen, apparatus, clothing, instruments, etc. so as to ensure that purchases have been properly recorded in the Inventory Register and that issues have been made only against proper authorization. Depreciation: See that depreciation has been written off against all the assets at the appropriate rates. Registers: Inspect the bonds, share scrips, title deeds of properties and compare their particulars with those entered into the property and investment registers. Inventories: Obtain inventories, especially of stocks and stores as at the end of the year and check a percentage of the items physically; also compare their total values with respective ledger balances. Management Representation and Certificate: Get proper Management Representation and Certificate with respect to various aspects covered during the course of audit.