| No: B-54 | Date: 22/04/2025 | ||
| Patient Name: RIJVAN KEDARBHAI GANCHI | |||
| Age: 3YRS | M/F: MALE | ||
| Address:- BENAP | |||
| D.O.A.: 18/04/2025 | D.O.D.: 22/04/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 2 | 3,000.00 | 6,000.00 |
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||