| No: B-317 | Date: 24/09/2025 | ||
| Patient Name: JISHA H.SADHU | |||
| Age: 6M | M/F: FEMALE | ||
| Address:- PATAN | |||
| D.O.A.: 22/09/2025 | D.O.D.: 24/09/2025 | ||
| Diagnosis: BRONCHOLITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 3,300.00 | 9,900.00 |
| TOTAL | 9900.00 | ||
| IN WORDS : NINE THOUSAND, NINE HUNDRED RUPEES ONLY | |||
| Signature | |||