| No: B-24 | Date: 13/04/2025 | ||
| Patient Name: VANSH AJAYBHAI PATANI | |||
| Age: 2YRS | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 09/04/2025 | D.O.D.: 13/04/2025 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 1,100.00 | 5,500.00 |
| TOTAL | 5500.00 | ||
| IN WORDS : FIVE THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||