| No: B-143 | Date: 27/06/2025 | ||
| Patient Name: DHANRAJ BHARATBHAI RABARI | |||
| Age: 4YRS | M/F: MALE | ||
| Address:- THARA | |||
| D.O.A.: 25/06/2025 | D.O.D.: 27/06/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 3,000.00 | 9,000.00 |
| TOTAL | 9000.00 | ||
| IN WORDS : NINE THOUSAND RUPEES ONLY | |||
| Signature | |||