Yashraj Kadam

Name of Child: Yashraj Kadam
Father’s Name: Santosh Kadam Mother’s Name: Snehal Kadam
Address: Saroj Building Chakdar, Flat no. 6, Tarun Bharat, Mumbai: 4000 99
Age: 16 years Date of Birth: 8/01/2001 Sex: [ M ] Male [ ] Female
Mobile No: (1) 9833989369 (2) 9594575456
No Of Sibling: Brother Sister: 1
Total Family Member’s: (Including Grand father, Grand mother, Uncle, Aunty): 5
Monthly Family Income: 20,000/-
House: [ Own] Owner Ship [ ] Rent ____ Maintenance Per Month : Rs.: 2,000/-
Child Diagnosis: ____________________________________________________
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Child History: FT, LSCS as fetal heart beat reduced, DCIAB, BW: 3.5 kgs , In ventilator for 3 days, noticed scissors in 1 years, so suggested CT scan by his paediatrician.
Current Therapies: PT
Therapy Cost per Month: 2,400/- [ ] Self-Financed [ ] ______________