| No: B-207 | Date: 02/08/2025 | ||
| Patient Name: BABO MELIBHA SOLANKI | |||
| Age: 1.5M | M/F: MALE | ||
| Address:- DELWADA | |||
| D.O.A.: 28/07/2025 | D.O.D.: 02/08/2025 | ||
| Diagnosis: VIRAL DIAHERIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 1,000.00 | 5,000.00 |
| TOTAL | 5000.00 | ||
| IN WORDS : FIVE THOUSAND RUPEES ONLY | |||
| Signature | |||