| No: B-225 | Date: 07/08/2025 | ||
| Patient Name: IESHA SOHIL MEMAN | |||
| Age: 2Y | M/F: FEMALE | ||
| Address:- PATAN | |||
| D.O.A.: 04/08/2025 | D.O.D.: 07/08/2025 | ||
| Diagnosis: FEVER, VOMITING WITH DEHYDARTION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 2,500.00 | 7,500.00 |
| TOTAL | 7500.00 | ||
| IN WORDS : SEVEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||