| No: B-284 | Date: 07/09/2025 | ||
| Patient Name: SARA SAHID MALPURA | |||
| Age: 6Y | M/F: FEMALE | ||
| Address:- BASU | |||
| D.O.A.: 05/09/2025 | D.O.D.: 07/09/2025 | ||
| Diagnosis: VIRAL DIAHERIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 2 | 3,500.00 | 7,000.00 |
| TOTAL | 7000.00 | ||
| IN WORDS : SEVEN THOUSAND RUPEES ONLY | |||
| Signature | |||