| No: B-366 | Date: 05/11/2025 | ||
| Patient Name: VIJAY DHARMENDRABHAI THAKOR | |||
| Age: 1.5M | M/F: MALE | ||
| Address:- AMRNESDA | |||
| D.O.A.: 01/11/2025 | D.O.D.: 05/11/2025 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 7200.00 | ||
| IN WORDS : SEVEN THOUSAND, TWO HUNDRED RUPEES ONLY | |||
| Signature | |||