HOSPITAL SAN JOSE DE ORTEGA Remisiones
NIT. 890700967-1 201910310278 - 1
CALLE 6 3-25 (Tel:2258120) si¥i/0.01/2010-01-01
r 075236567]
Paciente (Datos Basicos) ————-
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INombres y Apel
Documento de Identidad: CC 1075236587 Genero: Femenino Eda 23/04/1988 ~ 31 Ano(s)
Direccién: VEREDA VERGEL PUEBLO NUEVO Telefone: 3142372407
Zona: Rural
Responsable del Usuario: CRISTIAN JULIAN DUCUARA
\Aseguradora: ASOCIACION INDIGENA DEL Regimen: Subsiiado
[GEESE EEE Eee CAUIGA Esse ELa EEE E EEE POS HEC J
Datos de las Referencias ——————__ ——
frecha ingreso Fecha Egreso Servicio que Remite Especialidad
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