| No: B-221 | Date: 05/08/2025 | ||
| Patient Name: DHAIRYA ANUJI KAPDI | |||
| Age: 1.5Y | M/F: MALE | ||
| Address:- MOJARU | |||
| D.O.A.: 01/08/2025 | D.O.D.: 05/08/2025 | ||
| Diagnosis: SEPTICEMIA WITH FEVER WITH VOMITING | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 2,200.00 | 8,800.00 |
| TOTAL | 8800.00 | ||
| IN WORDS : EIGHT THOUSAND, EIGHT HUNDRED RUPEES ONLY | |||
| Signature | |||