| No: B-590 | Date: 03/04/2026 | ||
| Patient Name: BABO HIRAJIA THAKOR | |||
| Age: 1M | M/F: MALE | ||
| Address:- KHAKAHAL | |||
| D.O.A.: 29/03/2026 | D.O.D.: 03/04/2026 | ||
| Diagnosis: VIRAL FEVER AND ABDOMINAL PAIN | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 7500.00 | ||
| IN WORDS : SEVEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||