| No: B-523 | Date: 14/02/2026 | ||
| Patient Name: KEYUR SANJAY DEVIPUJAK | |||
| Age: 2y | M/F: MALE | ||
| Address:- KHARIGHARIYAL | |||
| D.O.A.: 11/02/2026 | D.O.D.: 14/02/2026 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 4,000.00 | 16,000.00 |
| TOTAL | 16000.00 | ||
| IN WORDS : SIXTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||