| No: B-130 | Date: 13/06/2025 | ||
| Patient Name: MOHAMAD ADIL SAIYAD | |||
| Age: 3Y | M/F: MALE | ||
| Address:- UNAVA | |||
| D.O.A.: 11/06/2025 | D.O.D.: 13/06/2025 | ||
| Diagnosis: THYPOID FEVER WITH VOMITING | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 3,600.00 | 10,800.00 |
| TOTAL | 10800.00 | ||
| IN WORDS : TEN THOUSAND, EIGHT HUNDRED RUPEES ONLY | |||
| Signature | |||