| No: B-370 | Date: 08/11/2025 | ||
| Patient Name: KHUSHI PRAKASHJI THAKOR | |||
| Age: 3M | M/F: FEMALE | ||
| Address:- SOPRA | |||
| D.O.A.: 06/11/2025 | D.O.D.: 08/11/2025 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 6,000.00 | 18,000.00 |
| TOTAL | 18000.00 | ||
| IN WORDS : EIGHTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||