| No: B-84 | Date: 13/05/2025 | ||
| Patient Name: VED KURANKUMAR PARMAR | |||
| Age: 3YRS | M/F: MALE | ||
| Address:- SHANKHALPUR | |||
| D.O.A.: 11/05/2025 | D.O.D.: 14/05/2025 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 4,000.00 | 16,000.00 |
| TOTAL | 16000.00 | ||
| IN WORDS : SIXTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||