| No: B-202 | Date: 28/07/2025 | ||
| Patient Name: HIMANSU LAXMAN AYAR | |||
| Age: 4Y | M/F: MALE | ||
| Address:- LIMGAMDA | |||
| D.O.A.: 26/07/2025 | D.O.D.: 28/07/2025 | ||
| Diagnosis: PNUMONIA WITH FEVER WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 1,000.00 | 3,000.00 |
| TOTAL | 3000.00 | ||
| IN WORDS : THREE THOUSAND RUPEES ONLY | |||
| Signature | |||