| No: B-8 | Date: 04/04/2025 | ||
| Patient Name: BABO PRAVIN PATANI | |||
| Age: 6M | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 01/04/2025 | D.O.D.: 04/04/2025 | ||
| Diagnosis: VIRAL FEVER WITH SEPTICEMIA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 2,875.00 | 11,500.00 |
| TOTAL | 11500.00 | ||
| IN WORDS : ELEVEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||