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Combined RCM Approval Form
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#
Patient ID
Patient Name
Approval for
ACM
State
Created Date
Updated Date
Infection Date
Days
Action
He
9435194158
Krishna Kanta
Patient Loss
Approved
Assam
Approved
Approved
29/12/23, 8:00 am
2/1/24, 9:56 am
He
ACM has to fill TLC,DLC Report
He
9925263899
Shaileshbhai Chotala
Patient Loss
Approved
Gujarat
Approved
Approved
29/12/23, 9:28 am
4/1/24, 3:59 am
He
ACM has to fill TLC,DLC Report
He
9865724096
Krishnan. Tk
Patient Loss
Approved
Tamil Nadu
Approved
Approved
29/12/23, 10:47 am
30/12/23, 4:06 am
He
ACM has to fill TLC,DLC Report
He
7708806203
Vijay Kumar.M
Patient Loss
Approved
Tamil Nadu
Approved
Approved
29/12/23, 10:51 am
30/12/23, 4:04 am
He
ACM has to fill TLC,DLC Report
He
8109279793
Raeesa
Patient Loss
Approved
Rajasthan
Approved
Approved
29/12/23, 11:24 am
30/12/23, 4:08 am
He
ACM has to fill TLC,DLC Report
He
9782467345
Narendra Singh Chouhan
Patient Loss
Approved
Rajasthan
Approved
Approved
29/12/23, 11:25 am
30/12/23, 4:05 am
He
ACM has to fill TLC,DLC Report
He
9314977288
Prem kanwar
Patient Loss
Approved
Rajasthan
Approved
Approved
29/12/23, 11:50 am
30/12/23, 4:09 am
He
ACM has to fill TLC,DLC Report
He
9496107267
PATNAIK.L
Patient Loss
Approved
Andhra Pradesh
Approved
Approved
30/12/23, 3:47 am
30/12/23, 7:29 am
He
ACM has to fill TLC,DLC Report
He
8066646675
Jayanth sarkar
Patient Loss
Approved
Karnataka
Approved
Approved
30/12/23, 5:12 am
30/12/23, 6:37 am
He
ACM has to fill TLC,DLC Report
He
8867675869
Manjula
Patient Loss
Approved
Karnataka
Approved
Approved
30/12/23, 5:13 am
30/12/23, 7:29 am
He
ACM has to fill TLC,DLC Report
He
9618426186
Ramu T
Patient Loss
Approved
Andhra Pradesh
Approved
Approved
30/12/23, 6:36 am
30/12/23, 7:28 am
He
ACM has to fill TLC,DLC Report
He
9778326676
Kunjikannan
Patient Loss
Approved
Kerala
Approved
Approved
30/12/23, 7:38 am
30/12/23, 9:25 am
He
ACM has to fill TLC,DLC Report
He
7594921175
Vijayan
Patient Loss
Approved
Kerala
Approved
Approved
30/12/23, 7:39 am
30/12/23, 9:25 am
He
ACM has to fill TLC,DLC Report
He
9446469139
Siby Thomas
Patient Loss
Approved
Kerala
Approved
Approved
30/12/23, 7:40 am
30/12/23, 9:25 am
He
ACM has to fill TLC,DLC Report
He
9744499947
Sindu Presannen
Patient Loss
Approved
Kerala
Approved
Approved
30/12/23, 7:41 am
30/12/23, 9:25 am
He
ACM has to fill TLC,DLC Report
He
8606603358
Adersh Manesh
Patient Loss
Approved
Kerala
Approved
Approved
30/12/23, 7:41 am
30/12/23, 9:25 am
He
ACM has to fill TLC,DLC Report
He
9645966610
Xavier Presad
Patient Loss
Approved
Kerala
Approved
Approved
30/12/23, 7:42 am
30/12/23, 9:26 am
He
ACM has to fill TLC,DLC Report
He
8467891165
Indramani Tiwari
Patient Loss
Approved
Uttar Pradesh
Approved
Approved
30/12/23, 8:48 am
30/12/23, 9:25 am
He
ACM has to fill TLC,DLC Report
He
9724265673
Pranil Sondarva
Patient Loss
Approved
Gujarat
Approved
Approved
30/12/23, 9:07 am
4/1/24, 4:01 am
He
ACM has to fill TLC,DLC Report
He
8919207251
Radha Madhav Sinha
Patient Loss
Approved
Assam
Approved
Approved
30/12/23, 9:25 am
2/1/24, 10:01 am
He
ACM has to fill TLC,DLC Report
He
9486778798
Sasirekaa.R
Patient Loss
Approved
Tamil Nadu
Approved
Approved
30/12/23, 11:05 am
2/1/24, 5:58 am
He
ACM has to fill TLC,DLC Report
He
9843711391
Suresh Kumar.M
Patient Loss
Approved
Tamil Nadu
Approved
Approved
30/12/23, 11:05 am
2/1/24, 6:00 am
He
ACM has to fill TLC,DLC Report
He
9632744100
Velu
Patient Loss
Approved
Tamil Nadu
Approved
Approved
30/12/23, 11:07 am
2/1/24, 5:59 am
He
ACM has to fill TLC,DLC Report
He
6374371211
Manikandan
Patient Loss
Approved
Tamil Nadu
Approved
Approved
30/12/23, 11:07 am
2/1/24, 6:01 am
He
ACM has to fill TLC,DLC Report
He
8610540900
Mayelsamy.M
Patient Loss
Approved
Tamil Nadu
Approved
Approved
30/12/23, 11:08 am
2/1/24, 5:59 am
He
ACM has to fill TLC,DLC Report
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