| No: B-260 | Date: 25/08/2025 | ||
| Patient Name: DHARVI VISHAL PATEL | |||
| Age: 12Y | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 22/08/2025 | D.O.D.: 25/08/2025 | ||
| Diagnosis: PNUEMONIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 1,000.00 | 3,000.00 |
| TOTAL | 3000.00 | ||
| IN WORDS : THREE THOUSAND RUPEES ONLY | |||
| Signature | |||