| No: B-454 | Date: 27/12/2025 | ||
| Patient Name: NOOR FAIJAL SERESIYA | |||
| Age: 2M | M/F: FEMALE | ||
| Address:- RAVIYANA | |||
| D.O.A.: 24/12/2025 | D.O.D.: 27/12/2025 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 2,400.00 | 9,600.00 |
| TOTAL | 9600.00 | ||
| IN WORDS : NINE THOUSAND, SIX HUNDRED RUPEES ONLY | |||
| Signature | |||