Request for Admission

Doc.no : 71334

     

Ward & Bed	General ward - GW-1 - Bed no: 1
Admitted Under	Dr. Poonam Patel

Type of Admission:	First Time
Reason for Admission :	Emergency

Referral By:	SANTUSHTI HOSPITAL PVT LTD
Patient Identification Band tied:
Patient Rights & Responsibilities explained:
Patient Made aware of surroundings and safety measures:

Created & Updated

By :Amit Kumar

At :