| No: B-264 | Date: 28/08/2025 | ||
| Patient Name: DHRUV H. AHIR | |||
| Age: 8Y | M/F: MALE | ||
| Address:- VAUVA | |||
| D.O.A.: 24/08/2025 | D.O.D.: 28/08/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 4000.00 | ||
| IN WORDS : FOUR THOUSAND RUPEES ONLY | |||
| Signature | |||