| No: B-216 | Date: 02/08/2025 | ||
| Patient Name: RAJ VIKRAM PATANI | |||
| Age: 7Y | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 31/07/2025 | D.O.D.: 02/08/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 3,000.00 | 9,000.00 |
| TOTAL | 9000.00 | ||
| IN WORDS : NINE THOUSAND RUPEES ONLY | |||
| Signature | |||