G. A.

R - 23
[See Rule 91]
MEDICAL CHARGES REIMBURSEMENT BILL FOR THE MONTH OF 08/2023

Name of Office/Department

Head of Account
: Public Health Engineering

: 025S221501001020006
2215
Grant No. : 0025

DDO Code & Name : 125010

Treasury Code & Name : Aizawl North Treasury

Bill No. & Date. : 2402523C01626/23/08/2023

Bill Details
Employee Family
member on whose Medical Treatment Relationship
Sl.No Employee Name Group Designation Date of Bitth Age Marital
behaulf bill is to be Relationship DOB
Status
reimbursed
1 ISAAC LALROCHAMA Group B Driver Special Grade 28/03/1968 GRACE Daughter 25/08/2008 14 Single

Beneficiary Details

Sl.No Name of Beneficiary IFSC Account No Remarks Bill Amount Recovery Amount Net Amount

1 RG019935-ISAAC LALROCHAMA SBIN0010056 30188445250 MR Bill 28328.00 0.00 28328.00

TOTAL 28328.00
 Digitally signed by
Signer: LALZUIMAWII
Date: Thursday, August 24, 2023 12:20 PM
Location: Aizawl,Mizoram
Reason:
125010

LALZUIMAWII
Department Users
Drawing and Disbursement Officer
Note
1. This order is digitally signed and therefore needs no physical signature.
2. Authenticity of this order can be verified from https://ifmis.mizoram.gov.in This order is legally valid as per the Information Technology Act 2000 and its subsequents amendments.
3. Tampering of this order will attract Penal Action.