| No: B-361 | Date: 30/10/2025 | ||
| Patient Name: RUTVIK SUNDAJI THAKOR | |||
| Age: 5.5Y | M/F: MALE | ||
| Address:- CHOGA | |||
| D.O.A.: 28/10/2025 | D.O.D.: 30/10/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 8000.00 | ||
| IN WORDS : EIGHT THOUSAND RUPEES ONLY | |||
| Signature | |||