| No: B-65 | Date: 27/04/2025 | ||
| Patient Name: FATEMA ABDUL VEPARI | |||
| Age: 5Y | M/F: FEMALE | ||
| Address:- PATAN | |||
| D.O.A.: 23/04/2025 | D.O.D.: 27/04/2025 | ||
| Diagnosis: PNUMONIA WITH FEVER WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 2,300.00 | 11,500.00 |
| TOTAL | 11500.00 | ||
| IN WORDS : ELEVEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||