| No: B-174 | Date: 15/07/2025 | ||
| Patient Name: DEVRAJSINH JASAVATSINH CHAUHAN | |||
| Age: 12Y | M/F: MALE | ||
| Address:- CHEKHLA AMIRGADH | |||
| D.O.A.: 14/07/2025 | D.O.D.: 15/07/2025 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 2 | 4,200.00 | 8,400.00 |
| TOTAL | 8400.00 | ||
| IN WORDS : EIGHT THOUSAND, FOUR HUNDRED RUPEES ONLY | |||
| Signature | |||