| No: B-500 | Date: 28/01/2026 | ||
| Patient Name: BHATIYO NAJIRBHAI MIR | |||
| Age: 9M | M/F: MALE | ||
| Address:- RAJKOT | |||
| D.O.A.: 20/01/2026 | D.O.D.: 28/01/2026 | ||
| Diagnosis: FEBRIAL SIUZEAR VOMITING DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 7 | 1,200.00 | 8,400.00 |
| TOTAL | 8400.00 | ||
| IN WORDS : EIGHT THOUSAND, FOUR HUNDRED RUPEES ONLY | |||
| Signature | |||