| No: B-678 | Date: 23/06/2026 | ||
| Patient Name: RIYANSHI MUKESHJI THAKOR | |||
| Age: 2Y | M/F: MALE | ||
| Address:- KANJARA | |||
| D.O.A.: 20/06/2026 | D.O.D.: 23/06/2026 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 5,000.00 | 20,000.00 |
| TOTAL | 20000.00 | ||
| IN WORDS : TWENTY THOUSAND RUPEES ONLY | |||
| Signature | |||