| No: B-90 | Date: 17/05/2025 | ||
| Patient Name: ARVA ABJALBHAI BELI | |||
| Age: 5Y | M/F: FEMALE | ||
| Address:- SAMI | |||
| D.O.A.: 14/05/2025 | D.O.D.: 17/05/2025 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 1,625.00 | 6,500.00 |
| TOTAL | 6500.00 | ||
| IN WORDS : SIX THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||