| No: B-541 | Date: 16/03/2026 | ||
| Patient Name: BABO VIJUJI RAJPUT | |||
| Age: 1D | M/F: MALE | ||
| Address:- RAMANDA | |||
| D.O.A.: 01/03/2026 | D.O.D.: 16/03/2026 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 16 | 1,000.00 | 16,000.00 |
| TOTAL | 16000.00 | ||
| IN WORDS : SIXTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||