| No: B-9 | Date: 05/04/2025 | ||
| Patient Name: DHRUMIL NIRAJ PATANI | |||
| Age: 3YRS | M/F: MALE | ||
| Address:- PATAN | |||
| D.O.A.: 02/04/2025 | D.O.D.: 05/04/2025 | ||
| Diagnosis: DIARRHOEA WITH VOMITING WITH DEHYDRATION | |||
| Particulars | Days | Unit Cost (Rs.) | Amount (Rs.) |
|---|---|---|---|
| TOTAL ( R/N/D )CHARGE | 4 | 1,125.00 | 4,500.00 |
| TOTAL | 4500.00 | ||
| IN WORDS : FOUR THOUSAND, FIVE HUNDRED RUPEES ONLY | |||
| Signature | |||