| No: B-535 | Date: 25/02/2026 | ||
| Patient Name: BHAVYAM RAMESHBHAI CHAUDHARI | |||
| Age: 3Y | M/F: MALE | ||
| Address:- RUVEL | |||
| D.O.A.: 22/02/2026 | D.O.D.: 25/02/2026 | ||
| Diagnosis: SEPTICEMIA WITH FEVER WITH VOMITING | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 3,500.00 | 10,500.00 |
| TOTAL | 10500.00 | ||
| IN WORDS : TEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||