| No: B-534 | Date: 25/02/2026 | ||
| Patient Name: VAIBHAV SACHI THAKOR | |||
| Age: 1.5Y | M/F: MALE | ||
| Address:- KADIWALA | |||
| D.O.A.: 21/02/2026 | D.O.D.: 25/02/2026 | ||
| Diagnosis: FEVER WITH BRONCHITIS | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 6 | 3,000.00 | 18,000.00 |
| TOTAL | 18000.00 | ||
| IN WORDS : EIGHTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||