| No: B-95 | Date: 21/05/2025 | ||
| Patient Name: DEV PARESHBHAI RABARI | |||
| Age: 3.5YRS | M/F: MALE | ||
| Address:- KHANPURDA | |||
| D.O.A.: 18/05/2025 | D.O.D.: 21/05/2025 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 2,375.00 | 9,500.00 |
| TOTAL | 9500.00 | ||
| IN WORDS : NINE THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||