ESTIMATE CERTIFICATE

TO WHOM SO EVER IT MAY CONCERN

This is to certify that Mr.Vitthal Dhondu Chaudhari 66 Years/Male R/O, At Post.

Khurhad ,Tal.- Pachora ,Dist.- Jalgaon, is admitted in our hospital for treatment of Avascular
Necrosis of Bilateral Femoral Head (Fical & arlet stage IV on the left side & grade III AVN on
the right side).
Patient will require Left total hip replacement (Total Hip Arthroplasty Under
General Anaesthesia).
The Total Estimated cost of expenses approximately RS. 4,50,000/-(four lakh
fifty thousand only)including hospital, medical, radiological & lab Investigation, blood
products, surgery Anaesthesia, Rehabilitation & physiotheraphy.
Patient Had not take benefit of Mahathma Jyotiba Phule Janarogya Yojna.

Account Name - SHREE SEVA HOSPITAL

Bank Name - Canara Bank
Account no. - 6099201000030
IFSC code - CNRB0006099
Branch - Ozar (mig),Tal.- Niphad, Dist.- Nashik

Yours Faithfully,

Dr.Vikram Patil
Reg.No.2016/07/2067
Shree Seva Hospital, Ozar (MIG),
Tal.- Niphad,Dist. – Nashik.