| No: B-160 | Date: 09/07/2025 | ||
| Patient Name: ANSH SANJAYBHAI SUTHAR | |||
| Age: 13Y | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 07/07/2025 | D.O.D.: 09/07/2025 | ||
| Diagnosis: PNUEMONIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 3,800.00 | 11,400.00 |
| TOTAL | 11400.00 | ||
| IN WORDS : ELEVEN THOUSAND, FOUR HUNDRED RUPEES ONLY | |||
| Signature | |||