TSTC FORM - 58

Bill for Medical Reimbursement (Retired Employees)

FOR THE MONTH & YEAR 2 & 2022
Dist: Nirmal (For Treasury use only)

Date: 15-02-2022
TBR No: 20210000000991
Trans ID:

Teasury/ PAO Major Head: 2071 (Pension and Other

CODE: Retirement Benefits)
DDO CODE: 04012203001 Sub Major Head: 01 (Civil)
DDO Designation: EXECUTIVE Minor Head: 800 (Other Expenditure)
ENGINEER PR Group Sub Head: 00 (Not Applicable)
DDO Office Name: Office Of The Sub Head: 06 (Contribution to
Executive Engineer Contribution Pension
V&QC PR Divsion Scheme of Telangana State
Nirmal Aided Education Institutional
BANK BRANCH 504004451 Employees)
CODE: Detailed Head: 040 (Pensionary Charges)
BANK BRANCH NIRMAL Sub Detailed Head: 043 (Medical
NAME: Reimbursement)

NON-PLAN VOTED Non-contingency Fund MH/ Service Major Head : 2215

Gross: 47,561.00 PT Dedn: 0.00 TDS(IT): 0.00 GST: 0.00 GIS: 0.00
Net: 47,561.00

Passed for Rs: 47,561.00 (Rupees FORTY SEVEN THOUSAND FIVE HUNDRED SIXTY ONE Only) and the same
amount may be credited in A/c of MOHAMMED KHAZA .

Net
Bank Bank Amount(in
S.No Name A/c No Name Branch IFSC CODE Gross PT Dedn TDS(IT) GST GIS Rs.)

1 MOHAMMED 52135625457 STATE NIRMAL SBIN0020125 47,561.00 0.00 0.00 0.00 0.00 47,561.00
KHAZA BANK
OF
INDIA

Total: 47,561.00 0.00 0.00 0.00 0.00 47,561.00

Challan No(if any):

DDO's SIGNATURE

(FOR USE IN TREASURY / PAY & ACCOUNTS OFFICE ONLY)

Pay Rs_____________________________ (Rupees

___________________________________________________________________________________________________)
by
cash/cheque/Account credit

Treasury Officer/ PAY & ACCOUNTS Officer

Purpose

Medical Reimbursement Bill of Sri.MD.Khaja, Rtd.Driver of EE VQC PR Division, Nirmal for the period from
15.07.2021 to 21.12.2021

(Rupees FORTY SEVEN THOUSAND FIVE HUNDRED SIXTY ONE Only)

Designation of the Sanction Authority:- Office Of The Executive Engineer
V&QC PR Divsion Nirmal OFFICER, T.S. HYD.
Note: Original Sanction Order should be enclosed.

BUDGET PARTICULARS
Budget relaxed

Non-Drawal Certificate
Certified that no amount either in part or full pertining to the bill have been drawn an note to the effect
have been recorded
in the office copy and preserved in this office.

DDO's SIGNATURE

Budget Particulars
1.___________________________________________Yearly Estimated Budget
Rs.___________________________________

2.___________________________________________Amount including this bill

Rs.___________________________________

3.Balance_________________________________ Rs.___________________________________

Passed for Rs.47,561.00 Rupees FORTY SEVEN THOUSAND FIVE HUNDRED SIXTY ONE Only Paid By Cash/
Adjustment/
Cheque/ Draft.

DDO's
SIGNATURE