| No: B-149 | Date: 09/07/2025 | ||
| Patient Name: JAYESH BABUBHAI CHAUDHARI | |||
| Age: 2Y | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 29/06/2025 | D.O.D.: 09/07/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 11 | 2,000.00 | 22,000.00 |
| TOTAL | 22000.00 | ||
| IN WORDS : TWENTY-TWO THOUSAND RUPEES ONLY | |||
| Signature | |||