| No: B-417 | Date: 18/12/2025 | ||
| Patient Name: HARESH LAKHABHAI RABARI | |||
| Age: 7D | M/F: MALE | ||
| Address:- CHATAWADA | |||
| D.O.A.: 05/12/2025 | D.O.D.: 18/12/2025 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 14 | 2,000.00 | 28,000.00 |
| TOTAL | 28000.00 | ||
| IN WORDS : TWENTY-EIGHT THOUSAND RUPEES ONLY | |||
| Signature | |||