Cry To Smile Foundation PATIENT NAME

GOLU KUMAR

FATHER’S NAME

Satyendra Kumar Singh

GENDER Male

AGE OF PATIENT 4 Yrs

PERMANENT ADDRESS Village Bibi pur,Post Bhadwa, Rafiganj, Aurangabad, Bihar

CONTACT NUMBER 7677968449

DISEASE NAME Blood Cancer

DOCTOR NAME Dr. B R A IRHI

HOSPITAL NAME AIMS (All India Institute of Medical Science)

COST REQUIRED INR 2,50, 000/-

PATIENT’S FATHER’S

OCCUPATION

Labour

GAURDIAN SIGNATURE

Authorised Signatory