| No: B-344 | Date: 14/10/2025 | ||
| Patient Name: YANVI SACHIN CHAUDHARY | |||
| Age: 10M | M/F: FEMALE | ||
| Address:- MODLA | |||
| D.O.A.: 11/10/2025 | D.O.D.: 14/10/2025 | ||
| Diagnosis: PNUMONIA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 3,500.00 | 17,500.00 |
| TOTAL | 17500.00 | ||
| IN WORDS : SEVENTEEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||