| No: B-178 | Date: 23/07/2025 | ||
| Patient Name: BABY SHAILESH RABARI | |||
| Age: 2M | M/F: FEMALE | ||
| Address:- VARVADA | |||
| D.O.A.: 16/07/2025 | D.O.D.: 23/07/2025 | ||
| Diagnosis: VIRAL DIAHERIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 8 | 1,600.00 | 12,800.00 |
| TOTAL | 12800.00 | ||
| IN WORDS : TWELVE THOUSAND, EIGHT HUNDRED RUPEES ONLY | |||
| Signature | |||