| No: B-379 | Date: 16/11/2025 | ||
| Patient Name: MAYUR KISHAN THAKOR | |||
| Age: 16M | M/F: MALE | ||
| Address:- DHANODHARDA | |||
| D.O.A.: 13/11/2025 | D.O.D.: 16/11/2025 | ||
| Diagnosis: PNUMONIA WITH FEVER WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 8000.00 | ||
| IN WORDS : EIGHT THOUSAND RUPEES ONLY | |||
| Signature | |||