| No: B-129 | Date: 13/06/2025 | ||
| Patient Name: RAJVEER MUKESHSINH ZALA | |||
| Age: 9M | M/F: MALE | ||
| Address:- SUNSAR | |||
| D.O.A.: 11/06/2025 | D.O.D.: 13/06/2025 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 3,500.00 | 10,500.00 |
| TOTAL | 10500.00 | ||
| IN WORDS : TEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||