MAX CLBS- Best Liver Transplant in Delhi

Cadaver Patient Registartion Form

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Cadaver Patient Registartion Form

Kindly fill up the Cadaver Form with availability of Cadaver organ,we will get in touch with you to confirm the same.

Name :

Age :

Gender * :

Weight :

Blood Group :

Indian Citizen :

Address :

Patient Contact Number * :

E-mail id * :

Diagnosis * :

Fluid in Abdomen :

Leg swelling :

History of loss of Consiousness :

Bilirubine :

Albumin :

INR :

Creatinine :

Sodium :

AFP :

Date of Ultra sound last done :

Date of Ct Scan last done :

Upload Files :
(allowed file type - jpg/png/word/pdf)