| No: B-499 | Date: 24/01/2026 | ||
| Patient Name: NARESH DEVAJI THAKOR | |||
| Age: 6Y | M/F: MALE | ||
| Address:- ANAWADA | |||
| D.O.A.: 19/01/2026 | D.O.D.: 24/01/2026 | ||
| Diagnosis: PNUMONIA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 6 | 1,200.00 | 7,200.00 |
| TOTAL | 7200.00 | ||
| IN WORDS : SEVEN THOUSAND, TWO HUNDRED RUPEES ONLY | |||
| Signature | |||