भारत सरकार
|
Government of India
Patient Name: AMUL BAHPETEWAR
UHID: AIIMSBHPL_BHPL_AB_3005
Disease: X Linked Agammaglobulinemia
Estimate Cost of Treatment: 480,000
General Information
UHID : AIIMSBHPL_BHPL_AB_3005
Full Name : AMUL BAHPETEWAR
Mobile Number : 6264237180
Email Id : Ramprasadbahtewar9@gmail.com
Date of Registration : 2017-02-05
Gender : Male State of Domicile : Madhya Pradesh
Father's Name : RAMPRASAD BAHPETEWAR Father's Mobile Number : 9109534132
Mother's Name : MAMTA BAHPETEWAR Mother's Mobile Number : 6264237180
Name of Guardian/Care Taker: Mobile No. of Guardian/Care Taker : 0
Home Address (Current) Correspondance Address
Address Line 1 : 06 CHIKLA Address Line 1 : 06 CHIKLA
Address Line 2 : BALAGHAT Address Line 2 : BALAGHAT
City/Town : BALAGHAT City/Town : BALAGHAT
State/Province : Madhya Pradesh State/Province : Madhya Pradesh
Zipcode : 481226 Zipcode : 481226
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 : 480,000 BPL Card : Yes
Estimate Cost of Treatment : 480,000 Fund Required : Disease : X Linked Agammaglobulinemia
Disease : X Linked Agammaglobulinemia

Images

Videos