| No: B-626 | Date: 02/05/2026 | ||
| Patient Name: BABO DASARAT RABARI | |||
| Age: 7M | M/F: MALE | ||
| Address:- MANPURA | |||
| D.O.A.: 29/04/2026 | D.O.D.: 02/05/2026 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 3,500.00 | 14,000.00 |
| TOTAL | 14000.00 | ||
| IN WORDS : FOURTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||