| No: B-33 | Date: 17/04/2025 | ||
| Patient Name: SUNNY GANPATBHAI DEVIPUJAK | |||
| Age: 1YRS | M/F: MALE | ||
| Address:- SOKRA | |||
| D.O.A.: 12/04/2025 | D.O.D.: 17/04/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 6 | 1,000.00 | 6,000.00 |
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||