| No: B-131 | Date: 16/06/2025 | ||
| Patient Name: SHREYA MUKESHJI DARBAR | |||
| Age: 2Y | M/F: MALE | ||
| Address:- AGHAR | |||
| D.O.A.: 11/06/2025 | D.O.D.: 16/06/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 3,475.00 | 13,900.00 |
| TOTAL | 13900.00 | ||
| IN WORDS : THIRTEEN THOUSAND, NINE HUNDRED RUPEES ONLY | |||
| Signature | |||