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CS - 25

M.E.S Copy

Accounts Copy

U , ^U
LIFE INSURANCE CORPORATION OF INDIA
DIVISIONAL OFFICE, RAJAHMUNDRY
UUU MEDICAL FEE BILL

CODE

PROPOSAL
NO.

S
U
INITLS
OF PROP

UUU U
U
DATE OF
MEDI EXAM

U , ^U

LIFE INSURANCE CORPORATION OF INDIA


DIVISIONAL OFFICE, RAJAHMUNDRY
UUU MEDICAL FEE BILL

U MTH. OF A/C

CS - 25

S
U

SUM
PROPOSED

U M.
AMT OF FEE
Rs.

CODE

S
PROPOSAL
NO.

INITLS
OF PROP

UUU U
U
DATE OF
MEDI EXAM

S
U

SUM
PROPOSED

Office Copy

CS - 25

U , ^U

LIFE INSURANCE CORPORATION OF INDIA


DIVISIONAL OFFICE, RAJAHMUNDRY
UUU MEDICAL FEE BILL

U MTH. OF A/C

S
U

U M.
AMT OF FEE
Rs.

CODE

S
PROPOSAL
NO.

U MTH. OF A/C

S
U

INITLS
OF PROP

UUU U
U
DATE OF
MEDI EXAM

S
U

SUM
PROPOSED

U M.
AMT OF FEE
Rs.

A Cheque No. _____________________ Dated ___________ UU U

A Cheque No. ________________ Dated _______________UU U

A Cheque No. _________________ Dated ________________UU U

U UUU U U being medical fee as given above is sent herewith.

U UUU U U being medical fee as given above is sent herewith.

U UUU U U being medical fee as given above is sent herewith.