| No: B-316 | Date: 30/09/2025 | ||
| Patient Name: KUSH BHAVESH NAI | |||
| Age: 1.5M | M/F: MALE | ||
| Address:- KAMALPUR | |||
| D.O.A.: 22/09/2025 | D.O.D.: 30/09/2025 | ||
| Diagnosis: SEPTICEMIA WITH FEVER WITH VOMITING | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 8 | 1,500.00 | 12,000.00 |
| TOTAL | 12000.00 | ||
| IN WORDS : TWELVE THOUSAND RUPEES ONLY | |||
| Signature | |||