| No: B-26 | Date: 14/04/2025 | ||
| Patient Name: ARTI BALVANTJI THAKOR | |||
| Age: 4YRS | M/F: FEMALE | ||
| Address:- VAMIYA | |||
| D.O.A.: 10/04/2025 | D.O.D.: 14/04/2025 | ||
| Diagnosis: PNUMONIA WITH FEVER WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 1,600.00 | 8,000.00 |
| TOTAL | 8000.00 | ||
| IN WORDS : EIGHT THOUSAND RUPEES ONLY | |||
| Signature | |||