| No: B-443 | Date: 22/12/2025 | ||
| Patient Name: JAY JAINEEL PATEL | |||
| Age: 3M | M/F: MALE | ||
| Address:- MAKTUPUR | |||
| D.O.A.: 18/12/2025 | D.O.D.: 22/12/2025 | ||
| Diagnosis: FEBRIAL SIUZEAR VOMITING DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 2,000.00 | 10,000.00 |
| TOTAL | 10000.00 | ||
| IN WORDS : TEN THOUSAND RUPEES ONLY | |||
| Signature | |||