| No: B-401 | Date: 30/11/2025 | ||
| Patient Name: JAYSHINH PRAKASHSINH THAKOR | |||
| Age: 7Y | M/F: MALE | ||
| Address:- KHALIPUR | |||
| D.O.A.: 27/11/2025 | D.O.D.: 30/11/2025 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||