| No: B-376 | Date: 11/11/2025 | ||
| Patient Name: BABY BHARATBHAI RATHOD | |||
| Age: 9D | M/F: FEMALE | ||
| Address:- RAPAR | |||
| D.O.A.: 08/11/2025 | D.O.D.: 11/11/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 8000.00 | ||
| IN WORDS : EIGHT THOUSAND RUPEES ONLY | |||
| Signature | |||