| No: B-29 | Date: 15/04/2025 | ||
| Patient Name: SANVI AMITKUMAR PATANI | |||
| Age: 3YRS | M/F: FEMALE | ||
| Address:- GUL VASNA | |||
| D.O.A.: 11/04/2025 | D.O.D.: 15/04/2025 | ||
| Diagnosis: PNUMONIA WITH FEVER WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 2,320.00 | 11,600.00 |
| TOTAL | 11600.00 | ||
| IN WORDS : ELEVEN THOUSAND, SIX HUNDRED RUPEES ONLY | |||
| Signature | |||