| No: B-328 | Date: 11/10/2025 | ||
| Patient Name: JENISH ARVIND JOSHI | |||
| Age: 1M | M/F: MALE | ||
| Address:- DELMAL | |||
| D.O.A.: 07/10/2025 | D.O.D.: 11/10/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 5000.00 | ||
| IN WORDS : FIVE THOUSAND RUPEES ONLY | |||
| Signature | |||