| No: B-484 | Date: 16/01/2026 | ||
| Patient Name: BABO MAHESHJI THAKOR | |||
| Age: 6M | M/F: MALE | ||
| Address:- SOPRA | |||
| D.O.A.: 10/01/2026 | D.O.D.: 16/01/2026 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 6 | 1,800.00 | 10,800.00 |
| TOTAL | 10800.00 | ||
| IN WORDS : TEN THOUSAND, EIGHT HUNDRED RUPEES ONLY | |||
| Signature | |||