भारत सरकार
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Government of India
Patient Name: Tiya Jain
UHID: KEM_BOM_TJ_3024
Disease: wilson Disease
Estimate Cost of Treatment: 220,825
General Information
UHID : KEM_BOM_TJ_3024
Full Name : Tiya Jain
Mobile Number : 9769999717
Email Id : ketan717@yahoo.co.in
Date of Registration : 2014-11-22
Gender : Male State of Domicile : Maharashtra
Father's Name : Ketan Jain Father's Mobile Number : 9769999717
Mother's Name : Nikisha Jain Mother's Mobile Number : 9769999717
Name of Guardian/Care Taker: Ketan Jain Mobile No. of Guardian/Care Taker : 9769999717
Home Address (Current) Correspondance Address
Address Line 1 : 112, Neminath Darshan building ,A wing Address Line 1 : 112, Neminath Darshan building ,A wing
Address Line 2 : 604, Khadak road,Bhiwandi Address Line 2 : 604, Khadak road,Bhiwandi
City/Town : Mumbai City/Town : Mumbai
State/Province : Maharashtra State/Province : Maharashtra
Zipcode : 421308 Zipcode : 421308
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 : 220,825 BPL Card : Yes
Estimate Cost of Treatment : 220,825 Fund Required : Disease : wilson Disease
Disease : wilson Disease

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