| No: B-496 | Date: 24/01/2026 | ||
| Patient Name: RUDRA MAHIPALSINH VAGHELA | |||
| Age: 2Y | M/F: MALE | ||
| Address:- MUJPUR | |||
| D.O.A.: 17/01/2026 | D.O.D.: 24/01/2026 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 7 | 1,000.00 | 7,000.00 |
| TOTAL | 7000.00 | ||
| IN WORDS : SEVEN THOUSAND RUPEES ONLY | |||
| Signature | |||