| No: B-329 | Date: 10/10/2025 | ||
| Patient Name: MAHIR BHAVESH THAKOR | |||
| Age: 4M | M/F: MALE | ||
| Address:- SAMNA | |||
| D.O.A.: 07/10/2025 | D.O.D.: 10/10/2025 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 5,000.00 | 20,000.00 |
| TOTAL | 20000.00 | ||
| IN WORDS : TWENTY THOUSAND RUPEES ONLY | |||
| Signature | |||