UN 1 21AEOPD4245G1ZV TAXINVOICE Ph.: 06782-262828 : ) Bap LAXMI AYURVEDIC SEVA SADAN & AA UQESGe cael aoe ein Me: ROOM NO-5 0.T ROAD, NEW MARKET BUILDING, BALASORE-756001 Name of the Patient... asthe nat hereda,: Address... Name of the Doctor..... Date : Peed Bel eae 0 510a) 5 a | 3 aha Los reves Ie wb, | y]4e be a fey _I °eadiribuess,| | fo Ba Pines AP: BS @au &ga_ ace ‘caras ‘Balai E.&0.E.~YRE TOWN Rar ceROARY rnscere2.2e2aza) inder the DepartmenvOffice - -has been under my treatment for Ee to nescence of te aetinoootao of isd 2:8 HospitaVDispehESry/PHCINAC and that the under mentioned n serious deterioy at my consulti ihe medicines do not include preparations which are primarily foods, toilets or disinfectants. The ‘medicines do not include any of the items of thelist of inadmissible medicines and similar preparation reimbursing of Cost of which is not admissi ble to Government servants and their family members Name of the Medicines \- Ras Ray RAS: QXKOT- A MAHA YObRA GUGGUW- 1x YoT- S- maya LARA VAS RESO 2X 10T° y. ASHWAGHNDUD RIL: Spi b- UC Heaainistress, 7 ress, ye! i iris? AKA D. Barabati Govt.Girls' Hs, spe es His, ree Pri y begs Balasore, - alasore, ~" . i a Viauetormtane ‘ton leave or under suspension during the period of treatment referred to jMedicaopGogr 2 “Sout AARUSB RASA oe Pp i Jas cee OOM AREA I certify that my father/mother/father-in-lavi/mother-in-law (in case of female G ‘overnment Servant) is wholly/mainly dependent upon me and that no claims have been made for his/her during this period by any other Government servant. 7 Prgranall farO« Bryant Signatiite of the claimant. | certify that I was not abser in the above essentiality certificate.— AEOPD4245G1ZV TAX INVOICE of LAXMI AYURVEDIC SEVA SADAN 54, . MA AlQESSq 6AQ] ANE Sl.No, ROOM NO-5 0.T ROAD, NEW MARKET SUEDING, BALASORE-756001 Date A Name ofthe Patient... festa, e Name of the Doctor. DR...SENTIALITY CERTIFICATE on LELLBNOTH PZ ‘Son/daughter/wite/father/mother/husband of: 1 certify that Sri/Smn serving as. under the Department/Office .-has been under my treatment for GL LAE 22. at my consulting room/residence of the patient/indoorfoutdoor of. Hospital/Dispehsiry/PHC/NAC and that the under mentioned medicines were essentially necessary for prevention of serious deteriorations in the condition to the patient, ‘The medicines do not include preparations which are primarily foods, toilets or disinfectants. The medicines do not include any of the items of the list of inadmissible medicines and similar preparation reimbursing of cost of which is not admissible to Government servants and their family members. Name of the Medicines [+ RBS RAJ RBS: 2X\0T- A- MANP YOGRAY GuGGuLL’ 1X YOT- 425-60 3S- mp LAxmiv/Las Ros): (MOT y FETAL RE 2760-00 apy Cheb Uc Heauimitess, onxgpesand? Barabati Gevt.Girls? Heaghhistress, ritorbos HOMES! Bina HIS; parabati Govt.Girls! HIS, cera i Balasore. —~ Balasuie Town Balasore I certify that 1 was not absent on leave or under suspension during the period of treatment referred to in the above essentiality certificate. (hed . 2 none al es Ay Desgalgi | certify that my father/mother/father-in-lavi/mother-in-law (in case of femBlovG8yerhAseh PSERAN i is wholly/mainly dependent upon me and that no claims have been made for his/her during e&leerl6d/BW nS URRY Government servat Bizaanall’cters Rpssoanalt” 2 ni Signature attested Sibnlure of the cla pePxcrra officer Ay Medical O owtayurcesioispensn galasure Tow" ry in,Balasore(AEOPD4245G12V TAX INVOIC p LAXMI AYURVEDIC SEVA SADAN é MHI UQESSS cael age A = ROOM NO-50.T ROAD, NEW MARKET BUILDING, BALASORE-756001 Name of the Patient... £3. MONET! real LEE Name of the Doctor... uf Ih ty. Ef reestne [cn eo ! er 06782-262828 Amount & ‘| Ras reg cad : a | lia er x0 [21d R20 ABS BoD QO CO Ll atc te f Le E.&0.E. ponte phil et enn aToor th ‘Son/daughter/wife/father/motherihm under the DepartmentOfice has been under my treatment for 0b bd. on bile at my consulting robiifresidence of the paticnt/indoorfoutdoar o HospitaVDispeski@j/PHCMNAC and that the under mentioned medicines were essentially necessary for prevention of ns in the condition to the patient, ‘The medicines do not include preparations which are pri medicines do not include any of the items of the list of inadmissible medicines and similar prepa ‘cost of which is not admissible to Government servants and their family members. Name of the ies J}. ROS RMS ROL- 2RIOT- 2- MOHD YOGR GUGGUlY- (KYOT~ S- MAA LAXA/VILAS RIL @+ AA/IOT: 2/0+0 WU BSHNAGANDYD Rita 1 x ¥spinl- 70 | SO sr asaa otal PF Seon 5 ue esthebrass, 6 a Bese oO 1 or ‘ollicée Barabati Govt.Girls' H/S, Heal ifiatress, fy Moco sponse Balasore. Barabati Govt.Girls' H/S, so FiESE hy hfasost Balasore. 16 "aka Desig ation (seal) I certify that I was not absent on leave or under suspension during the period of treatment referred to in the above essentiality certificate. I certify that my father/mother/father-in-law/nother-in-law (i is wholly/mainly dependent upon me and that no claims have been made for his/her during thi BENGE Government servant. ? Preaansile PaneMs ~ Prgaenett Signature attested. fale} Dr. ‘aevllnee Ay Medical Officor Sovt Ayurcedic Dispensary Jalasuie Town,Balasore