| No: B-186 | Date: 22/07/2025 | ||
| Patient Name: KRISHIV MAHESH SOLANKI | |||
| Age: 2.5Y | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 19/07/2025 | D.O.D.: 22/07/2025 | ||
| Diagnosis: SEPTICEMIA WITH FEVER WITH VOMITING | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 3,700.00 | 14,800.00 |
| TOTAL | 14800.00 | ||
| IN WORDS : FOURTEEN THOUSAND, EIGHT HUNDRED RUPEES ONLY | |||
| Signature | |||