8/11/2019 Appeal for Funds for Medicines for Two Adolescents in Bombay

1/7

BAI

JERBAI

WADIA

HOSPITAL

FOR

CHILDREN

MEDICAL

SOCIAL

SERVICE

DEPARTMENT

Acharya

Donde

Marg,

parel,

Mumbai_

12.

Tel.24LZ

9786

/

g7,

Extn.

304.

fhis

is

to

certify

that

nraster

/

Miss

isacaseof

^aril

-

,

Case

Summary,/

Treatment

CERTIFICATE

Lq.-LL,-_

DCCTOR

0lo

Estimated

cost

of

treatment

.

l:i,esti5aiicn

o

fuledicines

o

D

ia

lysis

r

Surgery

r

lmplants

o

Blood

&

Blood

products

o

Bed

Charges

/

tpcU

/

NICU

:

Total

Cost

:

Signature

of

Unit

Name

of

Doctor

Registration

No.

Departrnent

/

\\,/arc|

.

[),itp

8/11/2019 Appeal for Funds for Medicines for Two Adolescents in Bombay

2/7

BAI

JERBAI

WADIA

HOSPITAL

FOR CHILDREN

MEDICAL

SOCIAL

SERVICE DEPARTMENT

Acharya

Donde

Marg,

Parel,

Mumbai-

12.

Tel.Z4L29786

/

87,

Extn.304.

DOCTOR

CERTIFICATE

This is

to certify

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nraster

/

Miss

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