| No: B-177 | Date: 19/08/2025 | ||
| Patient Name: SHREYA VIPUL SOLANKI | |||
| Age: 1M | M/F: FEMALE | ||
| Address:- DHANPURA | |||
| D.O.A.: 16/07/2025 | D.O.D.: 19/08/2025 | ||
| Diagnosis: PNUEMONIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 2,900.00 | 11,600.00 |
| TOTAL | 11600.00 | ||
| IN WORDS : ELEVEN THOUSAND, SIX HUNDRED RUPEES ONLY | |||
| Signature | |||