Claim ID: P20241011381

Land Acquisition Office, Murshidabad

Land Acquisition Office, Murshidabad Collectorate

No: 5LDHO209/R/1/2024 Dated: 11/06/2024

To
The District Magistrate
Office Of The Dm & Collector, Murshidabad.,
Office Of The Dm & Collector, Murshidabad.

Sub:- Recommending for financial sanction of WBHS claim of Sri Gour Gopal Mandal,
Supervisory Head Clerk
Sir / Madam ,
The undersigned is recommending to you to sanction the claim of West Bengal Health Scheme on the
basis of particulars stated below :

Sl. No Particulars Details

1. Registration No. of Pensioner WB/PEN/03/000081415
2. Name of Pensioner Sri Gour Gopal Mandal
3. Name of Patient Gour Gopal Mandal
4. Beneficiary ID of Patient 111685884/P/1/2
5. Relationship with the Pensioner Self
6. HoO Code of Head of Office where claim submitted. 5LDHO209

7. Designation of Head of Office where claim Special Land Acquisition Officer

submitted.
8. DDO Code of Drawing & Disbursing Officer where MUALRR003
claim submitted.
9. Designation of Drawing & Disbursing Officer where Spl. L.A.O. , Murshidabad
claim submitted.
10. Head of Account to charge 18-2071-01-800-00-002-12-00-V
11. Type of Treatment OPD Treatment
12. Name of Hospital where treatment availed B.M. Birla Heart Research Centre
13. Type of Hospital Empanelled
14. Claimed Amount Rs. 6878 /-
15. Provisional Admissible Amount Rs. 6878 /-
16. Name of Claimant (In case of death) and Relation N/A

Signature
Special Land Acquisition
Officer