BANK LETTERHEAD

To,

ENTITY RELATIONSHIP CERTIFICATE

This is to certify that-HOSPITAL NAME Hospital located at PLACE OF HOSPITAL is a proprietorship concern
and its Proprietor name is "HOSPITAL NAME" bearing Account No. ACCOUNT NUMBER with our bank-
Bank Name And IFSC Code-IFSC CODE.

As per our record the entity PAN Card No. PAN NUMBER and name on PAN card is "NAME ON THE
PAN CARD “.

This certificate is issued on a specific request of the party and the Bank doesn’t bear any financial
or other liability on the part of any of its officials.

Place :

Date : Branch manager

(sign and stamp of bank )