| No: B-73 | Date: 29/04/2025 | ||
| Patient Name: HEEBA MOHAMAD MANSIYA | |||
| Age: 1YRS | M/F: FEMALE | ||
| Address:- BHILWAN | |||
| D.O.A.: 26/04/2025 | D.O.D.: 29/04/2025 | ||
| Diagnosis: PNUMONIA | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL | 6000.00 | ||
| IN WORDS : SIX THOUSAND RUPEES ONLY | |||
| Signature | |||