| No: B-572 | Date: 19/03/2026 | ||
| Patient Name: AKSHU VIKRAM PATANI | |||
| Age: 3Y | M/F: FEMALE | ||
| Address:- DEVPURA | |||
| D.O.A.: 17/03/2026 | D.O.D.: 19/03/2026 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 2,000.00 | 6,000.00 |
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||