To,

The AGM Admn,

0/0 GM BA Jhansi. Date- 21-08-2021

Subject: Regarding reimbursement of Indoor treatment bill of my wife(Rekha kumari)in emergency

condition (Covid Viral Pneumonia) at Raghvendra hospital pvt. Ltd, Jhansi.

Sir,

With reference to above cited subject and reference kindly find herewith attached Medical
Reimbursement claim form (ERP claim number 00000000000000045092) for indoor treatment of my
wife (Rekha kumari) of Rs. 60843/- (sixty thousand eight hundred forty three only) for Covid Viral
pneumonia treatment at Raghvendra hospital pvt ltd. , Jhansi for reimbursement.

You are requested to kindly arrange for reimbursement of indoor treatment bill.

Thanking You.

Your’s Faithfully

Saroj kumar

(JTO Trans,jhansi)

HRMS no. – 200201064

Mobile no. - 9478632653