To, Dated: - 24.07.

2014
The Manager
Union Bank of India
Kaladhungi oad !ald"ani
Uttarakhand - 2#$1$%
Subject: - Deduction in Mediclaim Reimbursement of Parwati Shahi W/o.
Pratap Singh Shahi
!laim "mount Rs #$%$&'/- Reimbursement "mount '(%()(/-*
Dear &ir'Mada(,
I ha)e *lai(ed for (edi*al treat(ent of (+ "ife, ,ar"ati -hahi for Uteru- o.eration
done in /entral
!o-.ital, !ald"ani in 0ul+ 2014. Total e1.enditure "a- #$%$&'/- for thi- o.eration 2 I
ha)e .aid
thi- a(ount fro( (+ .er-onal -our*e-.
But again-t thi- *lai( I ha)e re*ei)e onl+ '(%()(/- that i- *redit in (+ a**ount on
13.07.14, a..ro1
'+%+))/- -traight dedu*ted 4+ (edi*al rei(4ur-e(ent de.art(ent.
I a( not in the .o-ition to a5ord lo-- of '+%+))/-. Thi- i- huge (one+ for (e 2 (+
6nan*ial *ondition
"ill 4e -u5er due to thi-.
&o +ou are kindl+ re7ue-ted .lea-e look into thi- (atter 2 arrange to rei(4ur-e the
4alan*e a(ount of
'+%+))/- at earlie-t a- I ha)e .ro)ided all -u..orting do*u(ent- in *onne*tion of -aid
*lai(.
8our i((ediate a*tion "ill 4e highl+ a..re*iated.
Thanking you,
Yours faithfully,
PRATAP SINGH SHAHI
,MP -o. ./$)$% Membership -o. #&'&*
,ncl. 0 1ero2 cop3 of !laim form along with all documents