भारत सरकार
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Government of India
Patient Name: SALMAAN FARIZ -.R
UHID: ICHHCE_CHEN_S-_4360
Disease: Hereditary angioedema (HAE)
Estimate Cost of Treatment: 5,000,000
General Information
UHID : ICHHCE_CHEN_S-_4360
Full Name : SALMAAN FARIZ -.R
Mobile Number : 9043496783
Email Id : salmaaneee@gmail.com
Date of Registration : 1993-05-18
Gender : Male State of Domicile : Tamil Nadu
Father's Name : Riswan .M Father's Mobile Number : 9043496783
Mother's Name : Narkes Banu Aleem .R Mother's Mobile Number : 9751913723
Name of Guardian/Care Taker: Mobile No. of Guardian/Care Taker : 0
Home Address (Current) Correspondance Address
Address Line 1 : No. 1/173, -17, Karthik nagar, Address Line 1 : No. 1/173, -17, Karthik nagar,
Address Line 2 : Nattamangalam, Madayankuttai post, Address Line 2 : Nattamangalam, Madayankuttai post,
City/Town : Salem City/Town : Salem
State/Province : Tamil Nadu State/Province : Tamil Nadu
Zipcode : 636452 Zipcode : 636452
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 : 5,000,000 BPL Card : Yes
Estimate Cost of Treatment : 5,000,000 Fund Required : Disease : Hereditary angioedema (HAE)
Disease : Hereditary angioedema (HAE)

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