| No: B-357 | Date: 28/10/2025 | ||
| Patient Name: PURVANSH NARESHBHAI PRAJAPATI | |||
| Age: 1Y | M/F: MALE | ||
| Address:- RADHANPUR | |||
| D.O.A.: 25/10/2025 | D.O.D.: 28/10/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 5,000.00 | 20,000.00 |
| TOTAL | 20000.00 | ||
| IN WORDS : TWENTY THOUSAND RUPEES ONLY | |||
| Signature | |||