The given statement is a counterfactual conditional. Ramya states, “Even if I had known that you were in the hospital...” which implies that she did not actually know about it.
- Option (A) is incorrect because if Ramya had already known, she would not have framed the sentence in this way.
- Option (B) is correct, as the statement suggests that Ramya did not know Josephine was in the hospital.
- Option (C) is incorrect because there is no information about their friendship status.
- Option (D) is incorrect because the statement does not mention the reason for Josephine’s hospitalization.
Thus, the correct answer is (B) Ramya did not know that Josephine was in the hospital.