Patient Trans –in form Jigme Dorji Patient Trans –in form Jigme Dorji

Wangchuck National Referral Hospital Wangchuck National Referral Hospital

Cabin Cabin

Patient Name: …………………………….. Patient Name: ……………………………..

Registration No: ………………………….. Registration No: …………………………..

Trans –in from ……….. To: …………….. Trans –in from ……….. To: ……………..

Trans – on: …………… Time:…………… Trans – on: …………… Time:……………

Patient Trans –in form Jigme Dorji Wangchuck Patient Trans –in form Jigme Dorji
National Referral Hospital Wangchuck National Referral Hospital
Cabin Cabin

Patient Name: …………………………….. Patient Name: ……………………………..

Registration No: ………………………….. Registration No: …………………………..

Trans –in from ……….. To: …………….. Trans –in from ……….. To: ……………..

Patient Trans –in form Jigme Dorji Wangchuck Patient Trans –in form Jigme Dorji
National Referral Hospital Wangchuck National Referral Hospital
Cabin Cabin

Patient Name: …………………………….. Patient Name: ……………………………..

Registration No: ………………………….. Registration No: …………………………..

Trans –in from ……….. To: …………….. Trans –in from ……….. To: ……………..

Patient Trans –in form Jigme Dorji

Patient Trans –in form Jigme Dorji Wangchuck
Wangchuck National Referral Hospital
National Referral Hospital
Cabin
Cabin
Patient Name: ……………………………..
Patient Name: ……………………………..
Registration No: …………………………..
Registration No: …………………………..
Trans –in from ……….. To: ……………..
Trans –in from ……….. To: ……………..