| No: B-352 | Date: 28/10/2025 | ||
| Patient Name: AKASH S.THAKOR | |||
| Age: 8M | M/F: MALE | ||
| Address:- GADSAI | |||
| D.O.A.: 24/10/2025 | D.O.D.: 28/10/2026 | ||
| Diagnosis: PNUMONIA WITH FEVER WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||