| No: B-121 | Date: 04/06/2025 | ||
| Patient Name: BABO KISHAN PATANI | |||
| Age: 1M | M/F: MALE | ||
| Address:- BHALGAM | |||
| D.O.A.: 04/06/2025 | D.O.D.: 09/06/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 3,500.00 | 17,500.00 |
| TOTAL | 17500.00 | ||
| IN WORDS : SEVENTEEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||