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Medical Claim Self Declaration Letter

The document is a letter to Cleartrip Pvt Ltd regarding a claim settlement for a canceled trip with Trip ID 230612216966 scheduled for July 22, 2023 to GAU. The letter declares that the person undergoing medical treatment is the traveler's family member and provides their relationship. It includes a copy of government issued identification for the patient.

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Saugat Modak
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202 views1 page

Medical Claim Self Declaration Letter

The document is a letter to Cleartrip Pvt Ltd regarding a claim settlement for a canceled trip with Trip ID 230612216966 scheduled for July 22, 2023 to GAU. The letter declares that the person undergoing medical treatment is the traveler's family member and provides their relationship. It includes a copy of government issued identification for the patient.

Uploaded by

Saugat Modak
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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To,

Cleartrip Pvt Ltd.,


9th floor, Tower A
Embassy Tech Village, Devarabeesanahalli, ORR,
Bangalore - 560103

Dear Sir/Madam,

This is regarding settlement of claim against Trip ID _____________________


230612216966 , Where I was
scheduled to travel to ____________________(destination)
GAU on ______________
22/07/23 (Date)I
hereby declare that the Person undergoing Medical Treatment is related to me and is my
_______________________________
me (Relationship)

Attached is the copy of Govt Issued Identification for the person undergoing treatment.

Thanks,

Name ________________________
SAUGAT MODAK

Signature SaugatModak
____________________ Date 22/07/22
________________

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