TSTC FORM - 58

FULLY VOUCHED CONTINGENT BILL

Bill for Medical Reimbursement
FOR THE MONTH & YEAR 11 & 2022
Dist: Sangareddy (For Treasury use only)

Date: 16-11-2022
TBR No: 20220000001255
Trans ID:

Teasury/ PAO CODE: Major Head: 2202 (General Education)

DDO CODE: 16042202101 Sub Major Head: 02 (Secondary Education)
DDO Designation: HM ZPHS GUMMADIDALA Minor Head: 191 (Assistance to Local Bodies for
DDO Office Name: ZPHS GUMMADIDALA Secondary Education)

BANK BRANCH CODE: 502004313 Group Sub Head: 00 (Not Applicable)

BANK BRANCH NAME: NARSAPUR Sub Head: 05 (Teaching Grants to Zilla Praja
Parishads)
Detailed Head: 010 (Salaries)
Sub Detailed Head: 017 (Medical Reimbursement)

NON-PLAN VOTED Non-contingency Fund MH/ Service Major Head : 2202

Gross: 12,000.00 PT Dedn: 0.00 TDS(IT): 0.00 GST: 0.00 GIS: 0.00
Telangana Haritha Nidhi: 0.00
Net: 12,000.00

Passed for Rs: 12,000.00 (Rupees TWELVE THOUSAND Only) and the same amount may be credited in A/c of SAMALA SANDEEP .

Net
Telangana Amount(in
S.No Name A/c No Bank Name Bank Branch IFSC CODE Gross PT Dedn TDS(IT) GST GIS Haritha Nidhi Rs.)

1 SAMALA 62274496242 STATE BANK BALAPUR X SBIN0003184 12,000.00 0.00 0.00 0.00 0.00 0.00 12,000.00
SANDEEP OF INDIA ROADS,
HYDERABAD

Total: 12,000.00 0.00 0.00 0.00 0.00 0.00 12,000.00

Challan No(if any):

DDO's SIGNATURE *

(FOR USE IN TREASURY / PAY & ACCOUNTS OFFICE ONLY)

Pay Rs_____________________________ (Rupees

___________________________________________________________________________________________________) by
cash/cheque/Account credit

Treasury Officer/ PAY & ACCOUNTS Officer

Purpose

medical reimbursement sanctioned bill s sandeep o/s

(Rupees TWELVE THOUSAND Only)

 Designation of the Sanction Authority:- ZPHS GUMMADIDALA OFFICER, T.S. HYD.
Note: Original Sanction Order should be enclosed.

BUDGET PARTICULARS
Budget relaxed

Non-Drawal Certificate
Certified that no amount either in part or full pertining to the bill have been drawn an note to the effect
have been recorded in the office copy and preserved in this
office.

DDO's SIGNATURE *

Budget Particulars
1.___________________________________________Yearly Estimated Budget
Rs.___________________________________

2.___________________________________________Amount including this bill

Rs.___________________________________

3.Balance_________________________________ Rs.___________________________________

Passed for Rs.12,000.00 Rupees TWELVE THOUSAND Only Paid By Cash/ Adjustment/
Cheque/ Draft.

DDO's SIGNATURE *

Signature Valid

S ARUN JYOTHI

(HM ZPHS GUMMADIDALA)

Dual Authenticated : 16-11-2022 3:08 PM