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Private Hospital Loan Form
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Private Hospital Loan Form
Private Hospital Loan Form
Hospital Name
*
Hospital Location
*
Years in Operation
*
Average Monthly Gross Income
*
Average Monthly Net Income
*
Contact Person Firstname
*
Contact Person Middlename
*
Contact Person Lastname
*
Contact Person Phone
*
Email
*
Desired Loan Amount
*
Loan Purpose
*
Bank Name
*
Bank Account Number
*
Bank Branch
*
Documents to be uploaded
6 Months Bank Statement
6 Months M-Pesa Statement (If using Till or Paybill for income collection)
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.
*