| No: B-623 | Date: 29/04/2026 | ||
| Patient Name: DEV HARSHAD PATEL | |||
| Age: 8Y | M/F: MALE | ||
| Address:- ISLAMPURA | |||
| D.O.A.: 27/04/2026 | D.O.D.: 29/04/2026 | ||
| Diagnosis: VIRAL AGE SOME DWHYDRATION WITH MESENTERIC ADEITIS WITH FEVER | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 3 | 5,000.00 | 15,000.00 |
| TOTAL | 15000.00 | ||
| IN WORDS : FIFTEEN THOUSAND RUPEES ONLY | |||
| Signature | |||