| No: B-385 | Date: 20/11/2025 | ||
| Patient Name: MANAS AJIT DESAI | |||
| Age: 12Y | M/F: MALE | ||
| Address:- CHAVELI | |||
| D.O.A.: 16/11/2025 | D.O.D.: 20/11/2025 | ||
| Diagnosis: PNUMONIA WITH FEVER WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 5000.00 | ||
| IN WORDS : FIVE THOUSAND RUPEES ONLY | |||
| Signature | |||