From

Y. NAGABHUSHANAM HYDERABAD
RETD.LSG BCR SA 16-3-2016
HRO RMS ‘Y’ DN
11-274, AMBATI NAGAR
MANGALAGIRI HO, 522 503
GUNTUR DIST, A.P

TO
THE ADDITIONAL DIRECTOR,
CGHS, BEGUMPET
HYDERABAD 500 016
[Through Himayatnagar wellness centre]

I humbly submit to the benign presence of kind addl. Director the medical
bill in r/o treatment to my wife in AYUSH HOSPITAL, Vijayawada after admission in
emergency. Her id cord no. 4132445 of Himayatnagar wellness centre, Hyderabad. I am resident
of Mangalagiri which is in non CGHS area and having cord on six monthly renewal basis.

On 22-1-2016 she was fell sudden sick with heart pain and breathing
problem. Immediately she was taken to AAYUSH HOSPITAL in Vijayawada which is
recognized by central govt. [a copy of the order is enclosed]. She was kept in ICU CARE
immediately and ANGIOGRAM was done on 28-1-2016 and decided to do operation
immediately.

As she was not in a position to move, she was shifted to cardiac ICU 2-2-
2016 and operation was done on 3-2-2016 and kept in ICU up to 11-2-2016 and afterwards
shifted to room and discharged on 17-2-2016.

For this entire treatment total expenditure incurred is Rs.5, 21,090-00/-

for which detail bill was produced along with this application. EMERGENCY CERTIFICATES
required were also attached with this bill.

As such kind CGHS ADDL. DIRECTOR is requested to sanction the bill

at an early date, as huge amount was incurred for treatment by taking loans, with a hope of early
sanction. I once again request you to sanction the bill early for which act of kindness I will be
thankful forever.
Be pleased to consider.
Thanking you sir,
Yours faithfully,

[Y. NAGABHUSHANAM]
ID NO. 4132443
HIMAYAT NAGAR WELL NESS CENTRE.
DA:. ALL BILLS, APPLICATION AND REQUIRED DOCUMENTS ATTACHED