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  • Cochlear

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    Kirthi Lala
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    This document contains patient particulars and contact information for Ashwin Lala, including his name, date of birth, ID number, contact numbers, medical aid details, and cochlear implant information. It lists his father's additional contact number and provides the name, postal address, residential address, email, and contact numbers for Ashwin Lala, who is responsible for the account. Medical aid details for Discovery health plan number 287542990 and dependent number 3 are also included.

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    This document contains patient particulars and contact information for Ashwin Lala, including his name, date of birth, ID number, contact numbers, medical aid details, and cochlear implant information. It lists his father's additional contact number and provides the name, postal address, residential address, email, and contact numbers for Ashwin Lala, who is responsible for the account. Medical aid details for Discovery health plan number 287542990 and dependent number 3 are also included.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as XLS, PDF, TXT or read online from Scribd
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    73 views1 page

    Cochlear

    Uploaded by

    Kirthi Lala
    This document contains patient particulars and contact information for Ashwin Lala, including his name, date of birth, ID number, contact numbers, medical aid details, and cochlear implant information. It lists his father's additional contact number and provides the name, postal address, residential address, email, and contact numbers for Ashwin Lala, who is responsible for the account. Medical aid details for Discovery health plan number 287542990 and dependent number 3 are also included.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as XLS, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    Download as xls, pdf, or txt
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    PATIENT PARTICULARS Surname: Date of Birth: ID No.: Kirthi First Name 25th May 1990 9.

    00525E+12 Lala

    If a child: Parents/Guardians Names: Siblings Names: Name of School: Telephone number of school: Name of therapist/s: Contact number of therapist:

    Ashwin lala University of Kwazulu Natal Leone

    PARTICULARS OF PERSON RESPONSIBLE FOR ACCOUNT: Title: Surname: Postal Address: Mr ID No.: Lala First Name: Cluster Box 6896 Hillcrest KZN 3626 Residential Address: 22 Alsace Le Domaine 101 Acutts Drive KZN 3626 Telephone: Home: 716 8293 031 Work Fax: Cell Email: ashwin603@gmail>com Additional Cell Numbers and relation to patient: Father 082 502 1204 2) MEDICAL AID DETAILS MEDICAL AID Discovery Membership No.: 287542990 Dependant No. of patient: 3 Telephone No. of Medical Aid: 0860 998877 Fax No. of Medical Aid: COCHLEAR IMPLANT INFORMATION(If unsure, leave blank) Implant Surgery Date: Aug-07 Implant Surgeon: Dr Garth Skinner Type of Implant: Right: Type of Processor: G4 Serial Number: Right: Colour: Black Left: Left: Left: Left: Left: Left: 6.40717E+12 Ashwin

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