| No: B-15 | Date: 10/04/2025 | ||
| Patient Name: IKRA IMRANBHAI MALEK | |||
| Age: 1.5 | M/F: MALE | ||
| Address:- RADHANPUR | |||
| D.O.A.: 06/04/2025 | D.O.D.: 10/04/2025 | ||
| Diagnosis: PNUMONIA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 1,200.00 | 6,000.00 |
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||