| No: B-524 | Date: 15/02/2026 | ||
| Patient Name: ARYA PRAVIN PATEL | |||
| Age: 3Y | M/F: FEMALE | ||
| Address:- PATAN | |||
| D.O.A.: 12/02/2026 | D.O.D.: 15/02/2026 | ||
| Diagnosis: SEPTICEMIA WITH FEVER WITH VOMITING | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 3,500.00 | 14,000.00 |
| TOTAL | 14000.00 | ||
| IN WORDS : FOURTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||