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  • Page 2 of The Medical Form: Certification Engineers Internationa Limited

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    Riaz Noorjahan
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    This 3 sentence summary provides the key details from the 2 page medical form document: The document is a 2 page medical form where the employee declares that the medical claim statements are true to the best of their knowledge and the expenses were incurred for a family member covered under the company's medical rules. The employee also certifies that their wholly dependent parent resides with them or not and the parent's total average income does not exceed the specified limits as outlined in the medical rules.

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    Medical

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    This 3 sentence summary provides the key details from the 2 page medical form document: The document is a 2 page medical form where the employee declares that the medical claim statements are true to the best of their knowledge and the expenses were incurred for a family member covered under the company's medical rules. The employee also certifies that their wholly dependent parent resides with them or not and the parent's total average income does not exceed the specified limits as outlined in the medical rules.

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    © All Rights Reserved
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    Download as pdf or txt
    28 views1 page

    Page 2 of The Medical Form: Certification Engineers Internationa Limited

    Uploaded by

    Riaz Noorjahan
    This 3 sentence summary provides the key details from the 2 page medical form document: The document is a 2 page medical form where the employee declares that the medical claim statements are true to the best of their knowledge and the expenses were incurred for a family member covered under the company's medical rules. The employee also certifies that their wholly dependent parent resides with them or not and the parent's total average income does not exceed the specified limits as outlined in the medical rules.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    of 1

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    CERTIFICATION ENGINEERS INTERNATIONA LIMITED
    Page 2 of the medical form
    I hereby declare that the statement made inthe medical
    claim are true to the best of my knowledge and belief.
    .
    The person for whom the medical expenses
    were incurred is a member of my family as
    defined under the Medical Rules.
    I am a member of Company's Medical
    Scheme.
    also certify that Shri / Smt
    IS a wholly
    dependent parent residing with me / not
    residing with me. The total average income
    of my dependent parents does not exceed
    Rs.l,SOOj- p.m. or Rs.18,OOOj-yearfrom all
    sources, as contained in Para 2.0 of Medical
    Rules.
    .
    .
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    . Strikeoutwhichever isnotappHcable.
    Em.,loyecSignature:
    Date: EmpNo:
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