| No: B-513 | Date: 06/02/2026 | ||
| Patient Name: KRISHNA PALABHAI RABARI | |||
| Age: 2M | M/F: FEMALE | ||
| Address:- KHADAK-SHIPAR | |||
| D.O.A.: 03/02/2026 | D.O.D.: 06/02/2026 | ||
| Diagnosis: SEPTICEMIA WITH FEVER WITH VOMITING | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 16000.00 | ||
| IN WORDS : SIXTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||