| No: B-382 | Date: 21/11/2025 | ||
| Patient Name: JIGAR DINESH DESAI | |||
| Age: AKOLI | M/F: MALE | ||
| Address:- AKOLI | |||
| D.O.A.: 15/11/2025 | D.O.D.: 21/11/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 9000.00 | ||
| IN WORDS : NINE THOUSAND RUPEES ONLY | |||
| Signature | |||