| No: B-345 | Date: 16/10/2025 | ||
| Patient Name: RUDRANSH ROHIT PATEL | |||
| Age: 9M | M/F: MALE | ||
| Address:- SABOSAN | |||
| D.O.A.: 13/10/2025 | D.O.D.: 16/10/2025 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||