| No: B-187 | Date: 23/07/2025 | ||
| Patient Name: KAIRAR JAHARA A. KOJAR | |||
| Age: 8D | M/F: FEMALE | ||
| Address:- HAIDARPURA | |||
| D.O.A.: 19/07/2025 | D.O.D.: 23/07/2025 | ||
| Diagnosis: FEVER WITH BRONCHITIS | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 3,700.00 | 18,500.00 |
| TOTAL | 18500.00 | ||
| IN WORDS : EIGHTEEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||