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  • Medical Reimbursement Ex PDF

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    Pintu pajai
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    The document is a medical expense reimbursement form used by Steel Authority of India Limited, Chandrapur Ferro Alloy Plant. It lists medical expenses incurred by an employee or their family members according to the company's rules. The form includes details of the date, bill number, doctor, patient, relationship, and amount for each expense. The total amount is noted and the employee signs before submitting for approval. The relevant department then reviews and recommends the reimbursable amount.

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    The document is a medical expense reimbursement form used by Steel Authority of India Limited, Chandrapur Ferro Alloy Plant. It lists medical expenses incurred by an employee or their family members according to the company's rules. The form includes details of the date, bill number, doctor, patient, relationship, and amount for each expense. The total amount is noted and the employee signs before submitting for approval. The relevant department then reviews and recommends the reimbursable amount.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    24 views1 page

    Medical Reimbursement Ex PDF

    Uploaded by

    Pintu pajai
    The document is a medical expense reimbursement form used by Steel Authority of India Limited, Chandrapur Ferro Alloy Plant. It lists medical expenses incurred by an employee or their family members according to the company's rules. The form includes details of the date, bill number, doctor, patient, relationship, and amount for each expense. The total amount is noted and the employee signs before submitting for approval. The relevant department then reviews and recommends the reimbursable amount.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 1

    , STEEL AUTHORITY OF INDIA LIMITED, CHANDRAPUR FERRO ALLOY PLANT

    MEDICAL EXPENSE REIMBURSEMENT FORM (EXECUTIVES)

    Mentioned below are the expenses I have incurred towards the medical treatment and medicines for my family and myself, which have been
    in accordance with the rules and procedures of the company. The expenses may kindly be reimbursed.

    `
    Sl.No. Date Bill No. / Name of Shop Name of the doctor Name of the patient Relationship Amount (`)

    ` Total Amount (`)

    ( Signature of Employee)

    . . .
    / /

    FOR OFFICE USE ONLY :


    M&HS
    1. ` Recommended medical reimbursement amount (`)

    2. ` Taxable amount (`)

    Remarks

    / Signature . dt .
    Chief (M&HS) / ADMO(OH)

    Page 1 of 2

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