| No: B-422 | Date: 15/12/2025 | ||
| Patient Name: RUDRA BALKRUSHNA MODI | |||
| Age: 11Y | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 08/04/2025 | D.O.D.: 15/12/2025 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 8 | 1,600.00 | 12,800.00 |
| TOTAL | 12800.00 | ||
| IN WORDS : TWELVE THOUSAND, EIGHT HUNDRED RUPEES ONLY | |||
| Signature | |||