| No: B-608 | Date: 20/04/2026 | ||
| Patient Name: VISHWA VIKRAM THAKOR | |||
| Age: 15Y | M/F: FEMALE | ||
| Address:- MANVARPURA | |||
| D.O.A.: 15/04/2026 | D.O.D.: 20/04/2026 | ||
| Diagnosis: FEVER WITH CHIKANGUNIYA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 6 | 3,200.00 | 19,200.00 |
| TOTAL | 19200.00 | ||
| IN WORDS : NINETEEN THOUSAND, TWO HUNDRED RUPEES ONLY | |||
| Signature | |||