| No: B-161 | Date: 10/07/2025 | ||
| Patient Name: RAJ BHARAT PRAJAPATI | |||
| Age: 10Y | M/F: MALE | ||
| Address:- KANSHA | |||
| D.O.A.: 07/07/2025 | D.O.D.: 10/07/2025 | ||
| Diagnosis: PNUEMONIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 2,800.00 | 11,200.00 |
| TOTAL | 11200.00 | ||
| IN WORDS : ELEVEN THOUSAND, TWO HUNDRED RUPEES ONLY | |||
| Signature | |||