| No: B-188 | Date: 24/07/2025 | ||
| Patient Name: PRINCE DINESH YHAKOR | |||
| Age: 6Y | M/F: MALE | ||
| Address:- FINCHADI | |||
| D.O.A.: 20/07/2025 | D.O.D.: 24/07/2025 | ||
| Diagnosis: FEVER WITH BRONCHITIS | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 12500.00 | ||
| IN WORDS : TWELVE THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||