| No: B-351 | Date: 26/10/2025 | ||
| Patient Name: HENIL D. SONI | |||
| Age: 11Y | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 24/10/2025 | D.O.D.: 26/10/2025 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 3000.00 | ||
| IN WORDS : THREE THOUSAND RUPEES ONLY | |||
| Signature | |||