| No: B-150 | Date: 11/07/2025 | ||
| Patient Name: BABO VINAYBHAI RABARI | |||
| Age: 1M | M/F: MALE | ||
| Address:- VADU | |||
| D.O.A.: 30/06/2025 | D.O.D.: 11/07/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 12 | 2,000.00 | 24,000.00 |
| TOTAL | 24000.00 | ||
| IN WORDS : TWENTY-FOUR THOUSAND RUPEES ONLY | |||
| Signature | |||