Accommodations
 
PROFORMA FOR FREE ACCOMMODATION
Name* :
Age* :   Years.
Sex* :
Contact No* :
E-Mail* :
Address* :
Place* :
State* :
Country* :
Date of Surgery* :
Coming from which place* :
Mode of Transport* :
ID Proof* :      ID No :
 
Accompanying Person
Name* :    Age* : Years.  Sex* :
Relation* :

Note* :
1. Free Accommodation for 24 hrs only.
2. Food and other things extra.
* Conditions apply according to the Hotel.

For further details contact
Cell: +91 - 8008445511/22 (VIJAYAWADA)
Cell: +91-8008445533/44 (RAJAHMUNDRY)


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