| No: B-147 | Date: 30/06/2025 | ||
| Patient Name: MANDEEP AJITSINH JADEJA | |||
| Age: 2YRS | M/F: MALE | ||
| Address:- PAR | |||
| D.O.A.: 27/06/2025 | D.O.D.: 30/06/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 2 | 3,650.00 | 7,300.00 |
| TOTAL | 7300.00 | ||
| IN WORDS : SEVEN THOUSAND, THREE HUNDRED RUPEES ONLY | |||
| Signature | |||