| No: B-28 | Date: 14/04/2025 | ||
| Patient Name: ALVISH SURESHBHAI THAKOR | |||
| Age: 1.5YRS | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 11/04/2025 | D.O.D.: 14/04/2025 | ||
| Diagnosis: PNUMONIA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 1,500.00 | 7,500.00 |
| TOTAL | 7500.00 | ||
| IN WORDS : SEVEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||