| No: B-415 | Date: 08/12/2025 | ||
| Patient Name: BHVYA YOGESH PRAJAPATI | |||
| Age: 1Y | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 05/12/2025 | D.O.D.: 08/12/2025 | ||
| Diagnosis: DIABETES TRETMENT | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 2,800.00 | 11,200.00 |
| TOTAL | 11200.00 | ||
| IN WORDS : ELEVEN THOUSAND, TWO HUNDRED RUPEES ONLY | |||
| Signature | |||