| No: B-650 | Date: 25/05/2026 | ||
| Patient Name: SHREEYAN VIJAY PATEL | |||
| Age: 2Y | M/F: MALE | ||
| Address:- BODLA | |||
| D.O.A.: 21/05/2026 | D.O.D.: 25/05/2026 | ||
| Diagnosis: MESENTERIC ADENITIS WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 5 | 3,500.00 | 17,500.00 |
| TOTAL | 17500.00 | ||
| IN WORDS : SEVENTEEN THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||