| No: B-612 | Date: 23/04/2026 | ||
| Patient Name: AARAV ARVIND PANCHAL | |||
| Age: 5Y | M/F: MALE | ||
| Address:- THARA | |||
| D.O.A.: 18/04/2026 | D.O.D.: 23/04/2026 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 6 | 3,500.00 | 21,000.00 |
| TOTAL | 21000.00 | ||
| IN WORDS : TWENTY-ONE THOUSAND RUPEES ONLY | |||
| Signature | |||