In Association with

Kardiac Frontida
SRI SIDDHARTHA MEDICAL COLLEGE & HOSPITAL toheart
B.H. Road, Agalakote, Tumakuru We're here to heal

Mar. Status Hospital No.

Name

Service
Age gy Sex y
Ward ceM.R.D. ccupation
|grggoudo Religion Rate

Date NOTES Signature

Alamal Ru_funttti
elo clot24/ Vegcfatu
pasaly Collengn
 FRONTIO SIDDHARTHAADVANCED HEART CENTER
In Association with
Kardiac Frontida
SRI SIDDHARTHA MEDICAL COLLEGE &HOSPITAL to heart
B.H. Road, Agalakote, Tumakuru We're here to heal

Name Age Sex Mar. Status |Hospital No.

Service Ward M.R.D Occupation Religion Rate

Date NOTES Signature

Loa