| No: B-209 | Date: 01/08/2025 | ||
| Patient Name: ARJU IMRAN PATHAN | |||
| Age: 11Y | M/F: MALE | ||
| Address:- VADAVLI | |||
| D.O.A.: 28/07/2025 | D.O.D.: 01/08/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 2,000.00 | 10,000.00 |
| TOTAL | 10000.00 | ||
| IN WORDS : TEN THOUSAND RUPEES ONLY | |||
| Signature | |||