| No: B-59 | Date: 27/04/2025 | ||
| Patient Name: MISTI VISHALBHAI DARJI | |||
| Age: 3YRS | M/F: FEMALE | ||
| Address:- PATAN | |||
| D.O.A.: 22/04/2025 | D.O.D.: 27/04/2025 | ||
| Diagnosis: THYPOID FEVER WITH VOMITING | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 1,000.00 | 5,000.00 |
| TOTAL | 5000.00 | ||
| IN WORDS : FIVE THOUSAND RUPEES ONLY | |||
| Signature | |||