| No: B-609 | Date: 22/04/2026 | ||
| Patient Name: BABO RAJUBHAI RAVAL | |||
| Age: 3D | M/F: MALE | ||
| Address:- GANESHPURA | |||
| D.O.A.: 16/04/2026 | D.O.D.: 22/04/2026 | ||
| Diagnosis: VIRAL DIAHERIA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 7 | 3,000.00 | 21,000.00 |
| TOTAL | 21000.00 | ||
| IN WORDS : TWENTY-ONE THOUSAND RUPEES ONLY | |||
| Signature | |||