Referred To

No Of No.Of
Hospital Phone Name Of The Contact Govt Hopsitals No Of No Of No Of No Of Follow Up
SNO District Name Of The Nwh Mithra Name OP IP Onbed As-1 As-2 Preauth Telephonic Pre OP Post OP Remarks
Code Number Team Leader Number Under 133 Preauth Sent Surgeries Discharges Death Cases Done
Pending Cases
Procedures

1 HYDERABAD KAMINENI HOSPITAL HS549 KALAVATHI, RANGIAH 8374447273 BHASKAR 8374447244 NILL 4 1 3 0 3 0 0 0 0 2 1 2 0 0 NIL
 If not referred
If Yes, Mithra patient
Ramco Covered in 133 Counselled the Referred admitted in
Patient Registration Screened Investigations Procedures patient (Yes or hospital code Referred same NWH
s.no District Hospital name Patient Name Contact No. WAP NO. No. Patient District (Yes \No ) done (Yes/No) (Yes/NO) No) (HS) hospital name (Yes / No)

1 HYDERABAD KAMINENI HOSPITAL NILL NILL NILL NILL NILL NILL NILL NILL NILL NILL NILL NILL
 Referral Route
(Health Camp, Under 133
Patient Contact Surgical/Medica Surgery Done or
S.NO NWH District Hospital Name Claim No. Patient Name WAP NO. Patient District Customer Care,NWH Diagnosis Code Diagnosis Name Procedure (or) Remarks
No. l Not (Yes/No)
(Corporate) ,PHC, General
Direct,CMCO)

1 HYDERABAD KAMINENI-KING KOTI ASTRUST/KDP/2012/P3R4/11237231 G LAXMI 9652156230 WAP112200800424/01 YSR DIRECT S7.2.6.1 ) Intra Cardiac Repair Of Asd no SURGICAL yes NILL
2 HYDERABAD KAMINENI-KING KOTI ASTRUST/MBN/2012/P1R5/14251072 DAVOURI LALAMMA 9573586199 WAP140801600004/04 Mahbubnagar DIRECT ( S7.2.5.2 ) Total Correction Of Tetralogy Of Fallot no SURGICAL no NILL
3 HYDERABAD KAMINENI-KING KOTI ASTRUST/HYD/2013/P4R4/16263050 SHAHIDA 9291211530 WAP1671150B0076/02 Hyderabad DIRECT S7.2.1.1 ) Coronary Bypass Surgery( no SURGICAL no NILL

DISCHARGE