| No: B-320 | Date: 06/10/2025 | ||
| Patient Name: SHIDDH MANAN SHAH | |||
| Age: 11Y | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 29/09/2025 | D.O.D.: 06/10/2025 | ||
| Diagnosis: SEVER PNUMONIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 8 | 7,300.00 | 58,400.00 |
| TOTAL | 58400.00 | ||
| IN WORDS : FIFTY-EIGHT THOUSAND, FOUR HUNDRED RUPEES ONLY | |||
| Signature | |||