| No: B-133 | Date: 23/06/2025 | ||
| Patient Name: BABO IMTIYAJ BELIM | |||
| Age: 1M | M/F: MALE | ||
| Address:- THARA | |||
| D.O.A.: 12/06/2025 | D.O.D.: 23/06/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 11 | 2,500.00 | 27,500.00 |
| TOTAL | 27500.00 | ||
| IN WORDS : TWENTY-SEVEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||