| No: B-658 | Date: 10/06/2026 | ||
| Patient Name: MOHAMAD JED | |||
| Age: 3Y | M/F: MALE | ||
| Address:- KOITA | |||
| D.O.A.: 07/06/2026 | D.O.D.: 10/06/2026 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 4,500.00 | 18,000.00 |
| TOTAL | 18000.00 | ||
| IN WORDS : EIGHTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||