MADHYA PRADESH WOMEN POULTRY PRODUCERS

COMPANY PRIVATE LIMITED

A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relations Referred by Details of claim Amount

Bill claimed for hip with Doctor Name Fee/Medicine/ of Claim
claimant Tests/etc. (Rs.)
11/05/15 Yati Khare Daughter Dr. Vikrant Garg Fee + Medicine 250.00
05/09/15 Sangeeta Khare Wife Dr. Minakshi Patel Fee 300.00
05/09/15 Sangeeta Khare Wife Dr. Prashant P. Fee 200.00
Choubey
05/09/15 Sangeeta Khare Wife Dr. Minakshi Patel Test 1030.00
05/09/15 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 325.00
07/09/15 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 120.00
08/09/15 Sangeeta Khare Wife Dr. Prashant P. Medicine 258.00
Choubey
TOTAL (Rs) 2483 .00
In words – Rupees Two thousand four hundred eighty three only

Date: 09/09/2015

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relations Referred by Details of claim Amount

Bill claimed for hip with Doctor Name Fee/Medicine/ of Claim
claimant Tests/etc. (Rs.)
05/09/15 Yati Khare Daughter Dr. Vikrant Garg Fee + Medicine 250.00
26/09/15 Sangeeta Khare Wife Dr. Minakshi Patel Fee 300.00
26/09/15 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 326.00
03/10/15 Sangeeta Khare Wife Dr. Minakshi Patel Test 1200.00
10/10/15 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 223.00
TOTAL (Rs) 2299 .00
In words – Rupees Two thousand two hundred ninety nine only

Date: 13/10/2015

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relations Referred by Details of claim Amount

Bill claimed for hip with Doctor Name Fee/Medicine/ of Claim
claimant Tests/etc. (Rs.)
05/11/15 Sangeeta Khare Wife Dr. Minakshi Patel Fee 300.00
05/11/15 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 825.00
TOTAL (Rs) 1125.00
In words – Rupees One thousand one hundred only

Date: 09/10/2015

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relations Referred by Details of claim Amount

Bill claimed for hip with Doctor Name Fee/Medicine/ of Claim
claimant Tests/etc. (Rs.)
27/11/15 Yati Khare Daughter Dr. Vikrant Garg Fee + Medicine 320.00
03/12/15 Sangeeta Khare Wife Dr. Minakshi Patel Fee 300.00
03/12/15 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 627.00
04/12/15 Sangeeta Khare Wife Dr. Minakshi Patel Test 2200.00
06/12/15 Sangeeta Khare Wife Dr. Minakshi Patel Test 250.00
07/12/15 Sangeeta Khare Wife Dr. Minakshi Patel Test 1800.00
TOTAL (Rs) 5497.00
In words – Rupees Five Thousand four Hundred Ninety seven only

Date: 09/12/2015

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relations Referred by Details of claim Amount

Bill claimed for hip with Doctor Name Fee/Medicine/ of Claim
claimant Tests/etc. (Rs.)
04/01/16 Sangeeta Khare Wife Dr. Minakshi Patel Fee 300.00
05/01/16 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 1241.00
TOTAL (Rs) 1541.00
In words – Rupees One Thousand Five Hundred Forty One only

Date: 06/01/2016

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relations Referred by Details of claim Amount

Bill claimed for hip with Doctor Name Fee/Medicine/ of Claim
claimant Tests/etc. (Rs.)
05/02/16 Sangeeta Khare Wife Dr. Minakshi Patel Fee 300.00
06/02/16 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 957.00
07/02/16 Sangeeta Khare Wife Dr. Minakshi Patel Test 480.00
TOTAL (Rs) 1737.00
In words – Rupees One Thousand Seven Hundred thirty Seven only

Date: 09/02/2016

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relations Referred by Details of claim Amount

Bill claimed for hip with Doctor Name Fee/Medicine/ of Claim
claimant Tests/etc. (Rs.)
26/02/16 Yati Khare Daughter Dr. K. G. Malviya Fee 250.00
26/02/16 Yati Khare Daughter Dr. K. G. Malviya Medicine 191.00
29/02/16 Yati Khare Daughter Dr. K. G. Malviya Medicine 187.00
29/02/16 Yati Khare Daughter Dr. K. G. Malviya Medicine 182.00
TOTAL (Rs) 810.00
In words – Rupees Eight Hundred Ten only

Date: 08/04/2016

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relations Referred by Details of claim Amount

Bill claimed for hip with Doctor Name Fee/Medicine/ of Claim
claimant Tests/etc. (Rs.)
04/03/16 Sangeeta Khare Wife Dr. Minakshi Patel Fee 300.00
05/03/16 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 1482.00
20/03/16 Sangeeta Khare Wife Dr. Minakshi Patel Test 280.00
21/03/16 Sangeeta Khare Wife Dr. Minakshi Patel Fee 300.00
TOTAL (Rs) 2362.00
In words – Rupees Two Thousand Three Hundred Sixty Two only

Date: 08/04/2016

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relations Referred by Details of claim Amount

Bill claimed for hip with Doctor Name Fee/Medicine/ of Claim
claimant Tests/etc. (Rs.)
06/04/16 Sangeeta Khare Wife Dr. Minakshi Patel Fee 300.00
06/04/16 Sangeeta Khare Wife Dr. Minakshi Patel Test 530.00
06/04/16 Sangeeta Khare Wife Dr. Minakshi Patel Test 2500.00
07/04/16 Sangeeta Khare Wife Dr. Minakshi Patel Medicine 1517.00
TOTAL (Rs) 4847.00
In words – Rupees Four Thousand Eight Hundred Forty Seven only

Date: 08/04/2016

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
14/04/16 Sangeeta Khare Wife Dr. Vijaylakshmi Verma Medicine 8031.00
14/04/16 Sangeeta Khare Wife Dr. Vijaylakshmi Verma Medicine 1500.00
15/04/16 Sangeeta Khare Wife Dr. Vijaylakshmi Verma Medicine 334.00
18/04/16 Sangeeta Khare Wife Dr. Vijaylakshmi Verma Operation 46000.00
Charge &
Hospital
charge

TOTAL (Rs) 55865.00

In words – Rupees Fifty Five thousand Eight hundred Sixty Five only

Date: 22/04/2016

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
13/02/17 Raghuvier P Khare Father Dr. Rajesh Sethi Fee+ ECG 600.00
13/02/17 Raghuvier P Khare Father Dr. Rajesh Sethi Medicine 1177.00
18/03/17 Raghuvier P Khare Father Dr. Prerna Upadhya Fee 200.00
18/03/17 Raghuvier P Khare Father Dr. Prerna Upadhya Medicine 153.00
20/03/17 Raghuvier P Khare Father Dr. Rajesh Sethi Fee+ECG 600.00
22/03/17 Raghuvier P Khare Father Dr. Rajesh Sethi Medicine 589.00
26/03/17 Raghuvier P Khare Father Dr. Prerna Upadhya Make 600.00
Goggle
TOTAL (Rs) 3919.00
In words – Rupees Three thousand nine hundred nineteen only

Date: 01/04/2017

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
07/02/17 Yukti Khare Daughter Dr. K. G. Malviya Vaccination 300.00
08/02/17 Yukti Khare Daughter Dr. J. P. Khare Fee 200.00
08/02/17 Yukti Khare Daughter Dr. J. P. Khare Medicine 278.00
TOTAL (Rs) 778.00
In words – Rupees Seven hundred seventy eight only

Date: 01/04/2017

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
02/04/17 Yukti Khare Daughter Dr. J. P. Khare Fee 200.00
02/04/17 Yukti Khare Daughter Dr. J. P. Khare Medicine 75.00
03/04/17 Raghuvier P Khare Father Dr. Rajesh Sethi TMT Test 1500.00
03/04/17 Raghuvier P Khare Father Dr. Rajesh Sethi Medicine 1662.00
08/04/17 Yati Khare Daughter Dr. K. G. Malviya Fee 250.00
08/04/17 Yati Khare Daughter Dr. K. G. Malviya Medicine 280.00
15/04/17 Yukti Khare Daughter Dr. K. G. Malviya Vaccination 1300.00
17/04/17 Yati Khare Daughter Dr. J. P. Khare Fee 200.00
17/04/17 Yati Khare Daughter Dr. J. P. Khare Medicine 234.00
TOTAL (Rs) 5701.00
In words – Rupees Five thousand seven hundred one only

Date: 19/04/2017

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
11/06/17 Smt. Sangeeta Khare Wife Dr. J. P. Khare Fee 200.00
11/06/17 Smt. Sangeeta Khare Wife Dr. J. P. Khare Medicine 51.00
12/06/17 Smt. Sangeeta Khare Wife Dr. J. P. Khare Test 650.00
17/06/17 Smt. Sangeeta Khare Wife Dr. J. P. Khare Fee 200.00
17/06/17 Smt. Sangeeta Khare Wife Dr. J. P. Khare Test 1800.00
19/06/17 Smt. Sangeeta Khare Wife Dr. J. P. Khare Medicine 1157.00
20/06/17 Yukti Khare Daughter Dr. K. G. Malviya Vaccination 1800.00
TOTAL (Rs) 5858.00
In words – Rupees Five thousand eight hundred fifty eight only

Date: 21/06/2017

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
25/06/17 Ashish Kumar Khare Self Dr. J. P. Khare Fee 200.00
25/06/17 Ashish Kumar Khare Self Dr. J. P. Khare Medicine 143.00
29/06/17 Yati Khare Daughter Dr. J. P. Khare Fee 200.00
29/06/17 Yati Khare Daughter Dr. J. P. Khare Medicine 241.00
TOTAL (Rs) 784.00
In words – Rupees Seven hundred eight four only

Date: 07/07/2017

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
24/07/17 Yukti Khare Daughter Dr. K. G. Malviya Vaccination 300.00
15/08/17 Yati Khare Daughter Dr. J. P. Khare Fee 200.00
15/08/17 Yati Khare Daughter Dr. J. P. Khare Medicine 100.00
24/08/17 Yukti Khare Daughter Dr. K. G. Malviya Vaccination 1700.00
24/08/17 Yukti Khare Daughter Dr. K. G. Malviya Medicine 140.00
TOTAL (Rs) 2440.00
In words – Rupees Two thousand four hundred forty only

Date: 26/08/2017

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
16/09/17 Yukti Khare Daughter Dr. J. P. Khare Fee 200.00
16/09/17 Yukti Khare Daughter Dr. J. P. Khare Medicine 144.00
TOTAL (Rs) 344.00
In words – Rupees Three hundred forty four only

Date: 22/09/2017

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
31/10/17 Sangeeta Khare Wife Dr. J. P. Khare Fee 200.00
31/10/17 Sangeeta Khare Wife Dr. J. P. Khare Medicine 124.00
04/11/17 Yukti Khare Daughter Dr. K. G. Malviya Vaccination 1300.00

TOTAL (Rs) 1624.00

In words – Rupees Three hundred forty four only

Date: 07/11/2017

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
05/12/17 Yukti Khare Daughter Dr. J. P. Khare Fee 200.00
05/12/17 Yukti Khare Daughter Dr. J. P. Khare Medicine 168.00
10/12/17 Ashish Kumar Khare Self Dr. J. P. Khare Fee 200.00
10/12/17 Ashish Kumar Khare Self Dr. J. P. Khare Medicine 168.00

TOTAL (Rs) 749.00

In words – Rupees Seven hundred forty nine only

Date: 20/12/2017

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
18/01/18 Yati Khare Daughter Dr. J. P. Khare Fee 200.00
18/01/18 Yati Khare Daughter Dr. J. P. Khare Medicine 163.00
20/01/18 Sangeeta Khare Wife Dr. Sunit Bajpai Fee & 200.00
Medicine
20/01/18 Yati Khare Daughter Dr. Sunit Bajpai Fee & 120.00
Medicine
22/01/18 Yukti Khare Daughter Dr. J. P. Khare Fee 200.00
22/01/18 Yukti Khare Daughter Dr. J. P. Khare Medicine 121.00
24/01/18 Yukti Khare Daughter Dr. J. P. Khare Medicine 121.00

TOTAL (Rs) 1125.00

In words – Rupees One thousand one hundred twenty five only

Date: 27/01/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
09/04/18 Yukti Khare Daughter Dr. J. P. Khare Fee 200.00
09/04/18 Yukti Khare Daughter Dr. J. P. Khare Medicine 76.00

TOTAL (Rs) 276.00

In words – Rupees Two hundred seventy six only

Date: 04/05/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
28/02/18 Yati Khare Daughter Dr. S.P. Ahirwar Fee 150.00
28/02/18 Yati Khare Daughter Dr. S.P. Ahirwar Medicine 194.00
01/03/18 Yukti Khare Daughter Dr. Rameshwar Patel Fee 100.00
01/03/18 Yukti Khare Daughter Dr. Rameshwar Patel Medicine 399.00
02/03/18 Yukti Khare Daughter Dr. Rameshwar Patel Medicine 131.00
03/03/18 Yukti Khare Daughter Dr. Rameshwar Patel Medicine 154.00
TOTAL (Rs) 1128.00
In words – Rupees One thousand one hundred twenty eighty only

Date: 06/03/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
11/06/18 Yati Khare Daughter Dr. K. G. Malviya Vaccination 300.00
11/06/18 Yukti Khare Daughter Dr. K. G. Malviya Vaccination 1400.00

TOTAL (Rs) 1700.00

In words – Rupees One thousand seven hundred only

Date: 13/06/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
29/06/18 Yukti Khare Daughter Dr. J. P. Khare Fee 200.00
29/06/18 Yukti Khare Daughter Dr. J. P. Khare Medicine 195.00

TOTAL (Rs) 395.00

In words – Rupees Three hundred ninety five only

Date: 02/07/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
11/07/18 Ashish Kumar Khare Self Dr. J. P. Khare Fee 200.00
11/07/18 Ashish Kumar Khare Self Dr. J. P. Khare Medicine 243.00
11/07/18 Smt Sangeeta Khare Wife Dr. J. P. Khare Fee 200.00
11/07/18 Smt Sangeeta Khare Wife Dr. J. P. Khare Medicine 139.00
15/07/18 Ashish Kumar Khare Self Dr. J. P. Khare Test 550.00
15/07/18 Ashish Kumar Khare Self Dr. J. P. Khare Medicine 211.00
16/07/18 Ashish Kumar Khare Self Dr. J. P. Khare Fee 200.00
16/07/18 Ashish Kumar Khare Self Dr. J. P. Khare Medicine 501.00
TOTAL (Rs) 2244.00
In words – Rupees Two thousand two hundred forty four only

Date: 17/07/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
01/08/18 Ashish Kumar Khare Self Dr. J. P. Khare Fee 200.00
01/08/18 Ashish Kumar Khare Self Dr. J. P. Khare Medicine 447.00
01/08/18 Ashish Kumar Khare Self Dr. Akshay Nahar Fee 250.00
01/08/18 Ashish Kumar Khare Self Dr. Akshay Nahar X Rey 500.00
01/08/18 Ashish Kumar Khare Self Dr. Akshay Nahar Medicine 992.00
03/08/18 Ashish Kumar Khare Self Dr. Akshay Nahar Injection 40.00
05/08/18 Ashish Kumar Khare Self Dr. Akshay Nahar Injection 40.00
05/08/18 Smt Sangeeta Khare Wife Dr. Lata Singh Fee 250.00
05/08/18 Smt Sangeeta Khare Wife Dr. Lata Singh Medicine 328.00
TOTAL (Rs) 3047.00
In words – Rupees Three thousand forty seven only

Date: 07/08/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
03/09/18 Ashish Kumar Khare Self Dr. J. P. Khare Test 450.00
04/09/18 Ashish Kumar Khare Self Dr. J. P. Khare Fee 300.00
04/09/18 Ashish Kumar Khare Self Dr. J. P. Khare ECG 300.00
04/09/18 Ashish Kumar Khare Self Dr. J. P. Khare Sonography 1000.00
04/09/18 Ashish Kumar Khare Self Dr. J. P. Khare Test 859.00
04/09/18 Ashish Kumar Khare Self Dr. J. P. Khare Medicine 578.00
04/09/18 Ashish Kumar Khare Self Dr. Akshay Nahar Fee 200.00
04/09/18 Ashish Kumar Khare Self Dr. Akshay Nahar Medicine 735.00
TOTAL (Rs) 4422.00
In words – Rupees Four thousand four hundred twenty two only

Date: 05/09/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
30/09/18 Ashish Kumar Khare Self Dr. J. P. Khare Medicine 227.00
02/10/18 Yukti Khare Daughter Dr. J. P. Khare Fee 200.00
02/10/18 Yukti Khare Daughter Dr. J. P. Khare Medicine 117.00
TOTAL (Rs) 544.00
In words – Rupees Five hundred forty four only

Date: 09/10/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
11/10/18 Ashish Kumar Khare Self Dr. J. P. Khare Fee 300.00
11/10/18 Ashish Kumar Khare Self Dr. J. P. Khare Medicine 647.00
17/10/18 Ashish Kumar Khare Self Dr. J. P. Khare Test 1900.00

TOTAL (Rs) 2847.00

In words – Rupees Two thousand eight hundred forty seven only

Date: 29/10/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
14/10/18 Yati Khare Daughter Dr. J. P. Khare Fee 200.00
14/10/18 Yati Khare Daughter Dr. J. P. Khare Medicine 79.00
29/10/18 Yati Khare Daughter Dr. J. P. Khare Fee 200.00
29/10/18 Yati Khare Daughter Dr. J. P. Khare Medicine 166.00
29/10/18 Yukti Khare Daughter Dr. J. P. Khare Fee 200.00
29/10/18 Yukti Khare Daughter Dr. J. P. Khare Medicine 188.00
29/10/18 Ashish Kumar Khare Self Dr. Jaideep Khare Fee 300.00
29/10/18 Ashish Kumar Khare Self Dr. Jaideep Khare Medicine 360.00
TOTAL (Rs) 1693.00
In words – Rupees One thousand six hundred ninty three only

Date: 30/10/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
02/12/18 Ashish kumar khare Self Dr. Jaideep Khare Medicine 371.00
TOTAL (Rs) 371.00
In words – Rupees Three hundred seventy one only

Date: 08/12/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount

Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
20/12/18 Yati Khare Daughter Dr. J. P. Khare Fee 200.00
20/12/18 Yati Khare Daughter Dr. J. P. Khare Medicine 161.00
TOTAL (Rs) 361.00
In words – Rupees Three hundred sixty one only

Date: 28/12/2018

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
31/12/18 Ashish kumar khare Self Dr. Jaideep Khare Medicine 265.00
05/01/19 Ashish kumar khare Self Dr. Jaideep Khare Medicine 163.00

TOTAL (Rs) 428.00

In words – Rupees Four hundred twenty eight only

Date: 22/01/2019

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462 024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee – Ashish Kumar Khare

Designation – Logistic Assistant Place of posting – Mandideep

Date of Medical Expenses Relationshi Referred by Details of Amount
Bill claimed for p with Doctor Name claim of Claim
claimant Fee/Medici (Rs.)
ne/
Tests/etc.
03/02/19 Ashish kumar khare Self Dr. Jaideep Khare Fee 300.00
03/02/19 Ashish kumar khare Self Dr. Jaideep Khare Medicine 390.00
07/02/19 Ashish kumar khare Self Dr. Jaideep Khare Test 1260.00
08/02/19 Ashish kumar khare Self Dr. Jaideep Khare Medicine 366.00
TOTAL (Rs) 2316.00
In words – Rupees Two thousand three hundred sixteen only

Date: 09/02/2019

Signature of Claimant
For Office use only.
Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority

 MADHYA PRADESH WOMEN POULTRY PRODUCERS
COMPANY PRIVATE LIMITED
A – 101, Alkapuri, Bhopal – 462024 (M.P.)

MEDICAL EXPENSES CLAIM

Name of Employee: Designation: Ashish Kumar Khare

Place of Posting: Mandideep

Date of Bill Medical Relationship Referred by Details of claim Amount of

Expenses with Doctor Name Fee/Medicine/ Claim
claimed for claimant Tests/etc. (Rs.)
23/02/2019 Sangeeta Khare Wife Dr Jaideep Khare Fee 300.00
26/02/2019 Sangeeta Khare Wife Dr Jaideep Khare Test 2570.00
26/02/2019 Sangeeta Khare Wife Dr Jaideep Khare X Ray 350.00
26/02/2019 Sangeeta Khare Wife Dr Jaideep Khare Medicine 1396.00
TOTAL (Rs) 4616.00

In words: Four thousand six hundred sixteen only.

Date:27/02/2019

For Office use only. Signature of Claimant

Total Amount of Amount of claim made up to The Current claim of bill Balance Available
Entitlement (Rs.) the current bill(Rs) amount (Rs) amount at present

Verified by In-charge (Accounts) Approving Authority