| No: B-493 | Date: 22/01/2026 | ||
| Patient Name: RUTVIK CHETANJI CHAVDA | |||
| Age: 7Y | M/F: MALE | ||
| Address:- UNJHA | |||
| D.O.A.: 16/01/2026 | D.O.D.: 22/01/2026 | ||
| Diagnosis: SEPTICEMIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 7 | 1,500.00 | 10,500.00 |
| TOTAL | 10500.00 | ||
| IN WORDS : TEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||