,.: 06782. 8 “LAXMI Zv TAX INVOICE -262828 / fp LAXMI AYURVEDIC SEVA SADAN | ; ti V 2RKI0T: S-mpypaxmilasrac@- WOT. 5 gE sce 4. MAHA YOG RA GoGhl ieee Oth 580-0 TJoTAl RS 3 apy ( “4 uc Herth, esos, oA Bran Barabati Govt.Girls’ HIS, Barabeti Govt.Girls’ HIS, Siangjuresda alte et Balasore. Balasore, cb esignation (Seem Batasure 7 I certify that I was not absent on leave or under suspension during the period of treatment referred to in the above essentiality certificate. 2 ad Signdatee GR MENS . Desf Ls AD ary I certify that my father/mother/father-in-lav/mother-in-law (in case of female GawerinteESErvailly wry is wholly/mainly dependent upon me and that no claims have been made for his/her during this pBAidd B\PalR Siler Government servant, Y O19 @ige $179 | E1 DIGE Signature attested. Signature of the claimant. cot ayucee oer alasuie Tow- ABOPD4245G1ZV TAX INVOICE we LAXMI AYURVEDIC SEVA SADAN AC! UQsSGe cag age ROOM NO-5 0.T ROAD, NEW MARKET BUILDING, BALASORE-756001 Name of the Patient 72 ETAM IAL MUKA . Name of the Doctor . WR i.mcditlEt.P KAR QM. Etna [oe] we [ow | a [te [Vo. Vat Chéntamani nas] a004 [to 1xtorltyee- asan aqlloajaalae-erlac-c 690 JAX 107] 13/4281 990/9}|6/26 |32-8¢139-26 2S |1x10T| YOY: 6] Sq 234 07/23) f0,/2 Lexy a 25 | ixly7 1723-80 \cpoovad og/ap| 8-60] £.6 et geass olticer Total For Laxmi’ Ayurvedic Sevasadan, Ph.: 06782-262828 SI. No... Date :.0.8: ahaESSENTIALITY CERTIFICATE certify that Sri/Sint, GITA Sonfdaughterhvite ther/mother/husband of Sri ving as... under the Department/Office thas been under my treatment for | AMAUAT,2. - from. facdl 223. at my consulting room/residence of the patienindoorloutdook of. BY Hospital/Dispellsffy/PHC/NAC and that the under mentioned medicines were essentially necessary for prevention of serious deteriorations in the cor medicines do not inelude any of the items of the list of inadmissible medicines and similar preparation reimbursing of z $n to the patient. ‘The medicines do not inelude preparations which are primarily foods, toilets or disinfectants. ‘The cost of which is not admissible to Government servants and their family members ; ‘ame of the Mes Price Cin Rs) Is VRVATCHINTAMAN) RAC? 1 X/6T: / ant ‘ 2 SUTSWEKMAR RAS He). AXIOT: 1380 Se SS MAHBLAMIVILAS RAS G). 1 ALOT 4a Cre Us sami YORRAIGUG GLY eet BSB H05 Total RS | | 1 } } UC Headmistress, && Barabati Govt.cirls' HiS, Heaginistress, Signet ne Balasore, Barabati Govt.Girls’ H/S, ee gibtist Balasore. a | | certify that I was not absent on Teave or usder suspension during the period of treatment referred to in the above essentialty certificate. Le79-2 Signatugy ofa Mine Degignatinn(addd icc" | certify that my father/motherffather-in-awwhother-in-law (in case of female GoyezppmepiSetiaityrer a is wholly/iainly dependent upon me and that no claims have been made for his/her during this petay,py.ansotier = Government servant. YN) wt ae ere ae Signature attested ¢ lr + K.Pradnar ‘ay Medical officer GovLayurcedie Fispensar, alesuie Torr Signature of the claimant