| No: B-132 | Date: 12/06/2025 | ||
| Patient Name: FATEMA ARIFBHAI SUNSARA | |||
| Age: 1.5YRS | M/F: FEMALE | ||
| Address:- VADU | |||
| D.O.A.: 11/06/2025 | D.O.D.: 12/06/2025 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 3,725.00 | 14,900.00 |
| TOTAL | 14900.00 | ||
| IN WORDS : FOURTEEN THOUSAND, NINE HUNDRED RUPEES ONLY | |||
| Signature | |||