| No: B-426 | Date: 14/12/2025 | ||
| Patient Name: VIRENDRA DINESHJI JADAV | |||
| Age: 6Y | M/F: FEMALE | ||
| Address:- SAMUV | |||
| D.O.A.: 10/12/2025 | D.O.D.: 14/12/2025 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 2,500.00 | 12,500.00 |
| TOTAL | 12500.00 | ||
| IN WORDS : TWELVE THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||