| No: B-185 | Date: 22/07/2025 | ||
| Patient Name: RAFIK ANVAR MIR | |||
| Age: 14M | M/F: MALE | ||
| Address:- RAJKOT | |||
| D.O.A.: 18/07/2025 | D.O.D.: 22/07/2025 | ||
| Diagnosis: PNUEMONIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 3,800.00 | 19,000.00 |
| TOTAL | 19000.00 | ||
| IN WORDS : NINETEEN THOUSAND RUPEES ONLY | |||
| Signature | |||