| No: B-383 | Date: 18/11/2025 | ||
| Patient Name: RANI MERAJ AYAR | |||
| Age: 6Y | M/F: FEMALE | ||
| Address:- DEHGAM | |||
| D.O.A.: 16/11/2025 | D.O.D.: 18/11/2025 | ||
| Diagnosis: PNUMONIA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||