| No: B-324 | Date: 06/10/2025 | ||
| Patient Name: SWATI VIKRAM DEVIPUJAK | |||
| Age: 2Y | M/F: FEMALE | ||
| Address:- JASALPUR | |||
| D.O.A.: 02/10/2025 | D.O.D.: 06/10/2025 | ||
| Diagnosis: PNUMONIA WITH FEVER WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||