| No: B-57 | Date: 02/05/2025 | ||
| Patient Name: JISHA HARSHIL SADHU | |||
| Age: 5M | M/F: FEMALE | ||
| Address:- PATAN | |||
| D.O.A.: 22/04/2025 | D.O.D.: 02/05/2025 | ||
| Diagnosis: MAS WITH SEPTICEMIA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 10 | 300.00 | 3,000.00 |
| TOTAL | 3000.00 | ||
| IN WORDS : THREE THOUSAND RUPEES ONLY | |||
| Signature | |||