     </tr>

      <tr class="item">
        <td>
          Doctor Fee
        </td>

        <td>
          <input type="number" name="doctorFee" placeholder="In Rupees" value="">
        </td>
      </tr>

      <tr class="item">
        <td>
          Medicine Cost
        </td>

        <td>
          <input type="number" name="medicineCost" placeholder="In Rupees" value="">
        </td>
      </tr>

      <tr class="item last">
        <td>
          Other Charge
        </td>

        <td>
          <