| No: B-326 | Date: 06/10/2025 | ||
| Patient Name: MOHAMAD UJEF DAUVA | |||
| Age: 1.5Y | M/F: MALE | ||
| Address:- AMRAPURA | |||
| D.O.A.: 03/10/2025 | D.O.D.: 06/10/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 7200.00 | ||
| IN WORDS : SEVEN THOUSAND, TWO HUNDRED RUPEES ONLY | |||
| Signature | |||