| No: B-380 | Date: 16/11/2025 | ||
| Patient Name: TATHY SANDIP NAI | |||
| Age: 3M | M/F: MALE | ||
| Address:- BECHRAJI | |||
| D.O.A.: 11/11/2025 | D.O.D.: 16/11/2025 | ||
| Diagnosis: FEVER | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 5000.00 | ||
| IN WORDS : FIVE THOUSAND RUPEES ONLY | |||
| Signature | |||