भारत सरकार
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Government of India
Patient Name: Sai Surwase
UHID: KEM_BOM_SS_2291
Disease: Cystic Fibrosis
Estimate Cost of Treatment: 72,000
General Information
UHID : KEM_BOM_SS_2291
Full Name : Sai Surwase
Mobile Number : 7875212222
Email Id : vjnthsurwase@gmail.com
Date of Registration : 2017-11-30
Gender : Male State of Domicile : Maharashtra
Father's Name : Vaijnath Survase Father's Mobile Number : 7875212222
Mother's Name : Shital Surwase Mother's Mobile Number : 7875212222
Name of Guardian/Care Taker: Sai Surwase Mobile No. of Guardian/Care Taker : 0
Home Address (Current) Correspondance Address
Address Line 1 : Ta. Lohara, murshadpur Address Line 1 : Ta. Lohara, murshadpur
Address Line 2 : Murshadpur, sastur Address Line 2 : Murshadpur, sastur
City/Town : Osmanabad City/Town : Osmanabad
State/Province : Maharashtra State/Province : Maharashtra
Zipcode : 413606 Zipcode : 413606
Country : India Country : India
Details
Patient Proof ID : Patient ID Proof Upload : View file
Supporting (Father's/Mother's/Guardian/Care Taker)ID Proof : Supporting ID Proof Upload :
Annual Income of Family : Estimate Cost of Treatment : 72,000 BPL Card : Yes
Estimate Cost of Treatment : 72,000 Fund Required : Disease : Cystic Fibrosis
Disease : Cystic Fibrosis

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