patient details form - oceanfoundations.orgoceanfoundations.org/dipanshu.pdfdipanshu's father...

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Ocean Foundation Reg-353, Office address : D-127 3rd floor sector 10 Noida gautam budha nagar (201301) Website : www.oceanfoundations.org Email : [email protected] NAME DIPANSHU FATHER NAME PAWAN KUMAR CURRENT AGE 9 MONTHS SEX MALE DISEASE NAME Critical congenital heart disease (CCHD) HOSPITAL NAME AIIMS NEW DELHI ADDRESS #191 WARD NO: 113 SIRSA THE : SIRSA DISST.SIRSA HARYANA FATHER OCCUPATION labour C.V NUMBER 2016/014/0009651 UHID NUMBER 101721528 DOCTOR NAME DR. ANITA SAXENA TREATMENT REQUIRED OHS (open heart surgery) TREATMENT COST 45,000 RS DEPARTMENT OF TREATMENT CARDIOLOGY DEPTT. AIIMS NEW DELHI PATIENT DETAILS FORM DIPANSHU a little boy aged 9 MONTHS Year old he was recently diagnosed with Critical congential heart disease (CCHD) at AIIMS NEW DELHI under refrence of Dr. Anita Saxena. Dr. Anita Saxena asserted a treatment cost of Rs 45000. Dipanshu's father PAWAN from SIRSA (HARYANA) is a labour by profession and due to his bad financial condition is unable to bear the treatment amount and hence knocked at ocean foundation for the same and to save his son life and for his OHS (open hear surgery) we are arranging for the financial assistance. THANK YOU SO MUCH

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Ocean Foundation Reg-353,

Office address : D-127 3rd floor sector 10

Noida gautam budha nagar (201301)

Website : www.oceanfoundations.org

Email : [email protected]

NAME DIPANSHU

FATHER NAME PAWAN KUMAR

CURRENT AGE 9 MONTHS

SEX MALE

DISEASE NAME Critical congenital heart disease (CCHD)

HOSPITAL NAME AIIMS NEW DELHI

ADDRESS #191 WARD NO: 113 SIRSA THE : SIRSA DISST.SIRSA HARYANA

FATHER OCCUPATION labour

C.V NUMBER 2016/014/0009651

UHID NUMBER 101721528

DOCTOR NAME DR. ANITA SAXENA

TREATMENT REQUIRED OHS (open heart surgery)

TREATMENT COST 45,000 RS

DEPARTMENT OF TREATMENT CARDIOLOGY DEPTT. AIIMS NEW DELHI

PATIENT DETAILS FORM

DIPANSHU a little boy aged 9 MONTHS Year old he was recently diagnosed with Critical congential

heart disease (CCHD) at AIIMS NEW DELHI under refrence of Dr. Anita Saxena. Dr. Anita Saxena

asserted a treatment cost of Rs 45000. Dipanshu's father PAWAN from SIRSA (HARYANA) is a labour

by profession and due to his bad financial condition is unable to bear the treatment amount and

hence knocked at ocean foundation for the same and to save his son life and for his OHS (open hear

surgery) we are arranging for the financial assistance. THANK YOU SO MUCH