Varenyam Healthcare M00177

Alpesh Bhesaniya (E00495 - TM) - Rajkot Division : Critasia Medica Claim ID : C11111AEBC1 Month : May-24
Mobile No. : 8000694488
Base Other
Day Visit & Visit Loc. Route Day Type DA Kms Fare Add. Ded. Total
Station All.
SUREND
3 - Rajkot, 7 -
Rajkot> SURENDRANAGAR RANAG OS 800.00 110 220.00 1020.00
SURENDRANAGAR
1,We AR

SUREND
11 - SURENDRANAGAR SURENDRANAGAR> SURENDRANAGAR RANAG OS 800.00 0 0.00 800.00
2,Th AR

4 - Rajkot SURENDRANAGAR> Rajkot Rajkot Ex-HQ 235.00 55 275.00 510.00

3,Fr

1 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

4,Sa

0.00
5,Su

10 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

6,Mo

10 - Morbi, 2 - Rajkot Rajkot> Morbi Rajkot Ex-HQ 235.00 70 350.00 585.00

7,Tu

2 - Rajkot, 8 - UPLETA Rajkot> UPLETA Rajkot Ex-HQ 235.00 115 460.00 695.00
8,We

10 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

9,Th

10 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

10,Fr

9 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

11,Sa

0.00
12,Su

9 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

13,Mo

9 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

14,Tu

SUREND
10 - SURENDRANAGAR Rajkot> SURENDRANAGAR RANAG OS 800.00 110 220.00 235.00 1255.00
15,We AR
Rem :Daily allowance

7 - Rajkot, 2 -
SURENDRANAGAR> Rajkot Rajkot Ex-HQ 235.00 55 275.00 510.00
SURENDRANAGAR
16,Th

10 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

17,Fr

18,Sa 10 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

Page : 1 / 3
Alpesh Bhesaniya (E00495 - TM) - Rajkot Division : Critasia Medica Claim ID : C11111AEBC1 Month : May-24
Mobile No. : 8000694488
Base Other
Day Visit & Visit Loc. Route Day Type DA Kms Fare Add. Ded. Total
Station All.
18,Sa

0.00
19,Su

10 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

20,Mo

8 - Morbi, 1 - Rajkot Rajkot> Morbi Rajkot Ex-HQ 235.00 70 350.00 585.00

21,Tu

9 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

22,We

1 - Rajkot, 8 - UPLETA Rajkot> UPLETA Rajkot Ex-HQ 235.00 115 460.00 695.00
23,Th

9 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

24,Fr

9 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

25,Sa

0.00
26,Su

9 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

27,Mo

9 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

28,Tu

9 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

29,We

8 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

30,Th

10 - Rajkot Rajkot> Rajkot Rajkot HQ 235.00 0 0.00 235.00

31,Fr

Total 244 8040.00 700 2610.00 235.00 0.00 0.00 10885.00

Allownaces Amount Remarks Approver Remarks

Courier, Xerox, & Printout 150.00

Mobile Charges 250.00

Total 400.00

Type Amount Day Type #Days DA Leave Type #Leave Days

DA 8040.00 Ex HQ 6 1410.00 CL 0

TA 2610.00 HQ 18 4230.00 LWP 0

Other 235.00
OS 3 2400.00 PL 0
MA 400.00

Page : 2 / 3
 Alpesh Bhesaniya (E00495 - TM) - Rajkot Division : Critasia Medica Claim ID : C11111AEBC1 Month : May-24
Mobile No. : 8000694488

Type Amount Leave Type #Leave Days

Add. 0.00 SL 0

Ded. 0.00 Total 0

Total Billable

11285.00

Submitted by Alpesh Bhesaniya Approved By Rajesh Gevaria(ATM)

Submitted Amount 11285.00 Approved Amount 11285.00

Signature Signature

Date 03-06-2024 Date 06-06-2024

Page : 3 / 3