| No: B-10 | Date: 05/04/2025 | ||
| Patient Name: GAUTAM JAGDISH DESAI | |||
| Age: 2 | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 06/04/2025 | D.O.D.: 08/04/2025 | ||
| Diagnosis: DIABETES TRETMENT | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 2,250.00 | 9,000.00 |
| TOTAL | 9000.00 | ||
| IN WORDS : NINE THOUSAND RUPEES ONLY | |||
| Signature | |||