Mahindra & Mahindra Ltd - FES

MEDICAL ASSISTANCE SCHEME FOR OFFICERS

Claims for Medical Reimbursement against Annual Limit

Name S.SHANKAR Level L7 M Department: Sales & Co

Date of Submission 02/02/2010 Extn./Intercom No 9876003759 Token No 210881

Domiciliary Hospitalisation
Bill Spectacle Dental Maternity
Name TOTAL
Date Nature Of Amount Amount Amount Nature Of
Amount Amount
illness illness
Self S.Shankar 22/1/10 skin problem 124.5 124.5

23/1/10 skin problem 174 174

4/7/2009 Cold 129.5 129.5

21/10/10 Cold & fever 195 195

26/9/09 Stomach infection 118 118

23/4/09 Stomach infection 31 31

7/1/2010 Cold 75 75
21/1/10 skin problem 695 695

Wife Mrs. Rajeswari 11/1/2010 skin problem 193.5 193.5

11/12/2009 Pregency Scan 500 500

28/12/09 Pregency Checkup 252 252

11/12/2009 Pregency Checkup 154 154

11/1/2010 Pregency Checkup 95 95

11/1/2010 Test for Blood urine etc 1360 1360

Child

pass,9050

Instructions
1. Please submit Original bills and photocopy of Prescription. Signature Of
Total Claimed
2. Bills more than 3 months old will not be admissible. Employee 4096.5
3. Bills should be submitted before 30th of the month for inclusion in next
month pay roll. Medical Amount
4. Bills for the financial year should be submitted before 6th March. Administration Sanctioned
5. For any queries contact Medical Administration on 3340.
 Mahindra & Mahindra Ltd - FES
MEDICAL ASSISTANCE SCHEME FOR OFFICERS

Claims for Medical Reimbursement against Annual Limit

Name S.SHANKAR Level L7(O) Department: Sales & Co.

Date of Submission 02/03/2009 Extn./Intercom No 9876003759 Token No 210881

Domiciliary Hospitalisation
Bill Spectacle Dental Maternity
Name Nature Of Nature Of TOTAL
Date Amount Amount Amount Amount Amount
illness illness
Self S.SHANKAR 14.2.09 4992 4992

Wife

Child

Child

Instructions
1. Please submit Original bills and photocopy of Prescription. Signature Of
Total Claimed
2. Bills more than 3 months old will not be admissible. Employee 4992
3. Bills should be submitted before 30th of the month for inclusion in next
month pay roll. Medical Amount
4. Bills for the financial year should be submitted before 6th March. Administration Sanctioned
5. For any queries contact Medical Administration on 3340.