| No: B-322 | Date: 05/10/2025 | ||
| Patient Name: JIYANSH NARESHHAI PRAJAPARTI | |||
| Age: 1M | M/F: MALE | ||
| Address:- MESAR | |||
| D.O.A.: 01/10/2025 | D.O.D.: 05/10/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 6 | 5,000.00 | 30,000.00 |
| TOTAL | 30000.00 | ||
| IN WORDS : THIRTY THOUSAND RUPEES ONLY | |||
| Signature | |||