| No: B-179 | Date: 26/07/2025 | ||
| Patient Name: CHAYA RINABEN THAKOR | |||
| Age: 11M | M/F: FEMALE | ||
| Address:- SUNOK | |||
| D.O.A.: 17/07/2025 | D.O.D.: 26/07/2025 | ||
| Diagnosis: VIRAL DIAHERIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 10 | 1,400.00 | 14,000.00 |
| TOTAL | 14000.00 | ||
| IN WORDS : FOURTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||