Appendix 'A' (Refer to Para 7(a) of letter No B/49774 ... - Indian Army
Appendix 'A' (Refer to Para 7(a) of letter No B/49774 ... - Indian Army
Appendix 'A' (Refer to Para 7(a) of letter No B/49774 ... - Indian Army
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1. Provisional Diagnosis :<br />
2. Name <strong>of</strong> Hospital :<br />
3. Date and Time <strong>of</strong> Admission :<br />
4. Date and Time Information Received at Polyclinic :<br />
5. Remarks.<br />
Regd <strong>No</strong><br />
Date : Signature <strong>of</strong> OIC Polyclinic<br />
(Affix Polyclinic Stamp)<br />
Encl ‘1’<br />
19