adhaar.txt

MEDICAL ASSESSMENT FORM (FORM B}

 

Claimant name

Chinmay shimpi

 

Aadhar Number

624512348765

 

 

 

 

 

 

 

 

 

Address Mahatma Fule Nagar
Chandwad (Nashik)
Gender Male
Marital Status Unmarried
Date of Birth 01/03/1997
Occupation Engineer
Height 6 ft
Weight 60 kg
R/L Hand Dominant Yes
Date 20/02/2019

 

 

 

 

Brief details of the accident:

ith fever. P
Normal cough and cold wit
medication. This is second check up.

unable to take

atient feels weak due to lack of energy. He is