| No: B-25 | Date: 13/04/2025 | ||
| Patient Name: SUHANI SANJAYBHAI THAKOR | |||
| Age: 3YRS | M/F: FEMALE | ||
| Address:- NANA | |||
| D.O.A.: 09/04/2025 | D.O.D.: 13/04/2025 | ||
| Diagnosis: PNUMONIA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 1,300.00 | 6,500.00 |
| TOTAL | 6500.00 | ||
| IN WORDS : SIX THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||