SAMPLE ORDER COPY FOR WBHS 08
Government of West Bengal
WHEREAS Shri <incumbent>, <designation> of <Office> has submitted a prayer for granting medical reimbursement under clause 12 of the West Bengal Health Scheme – 2008 for an amount of ` 14,894/- (Rupees Fourteen Thousand Eight Hundred Ninety Four) only as an expenditure incurred for self treatment (Indoor) for the period on 06/01/2012. Sri <incumbent>, <designation> has undergone treatment as an indoor Patient on 06/01/2012 in Disha Eye Hospital & Research Centre Pvt Ltd. 88 (63A), Ghoshpara Road, Barrackpure, Kolkata – 700120 (Code No : 0411035) under West Bengal Health Scheme – 2008.
AND WHEREAS Sri <incumbent>, <designation>, has come under the purview of WBHS – 08 with Identity No. : <WBHS ID No.>.
AND WHEREAS Shri <incumbent>, <designation> has submitted all the requisite documents in support of his prayer of reimbursement.
NOW, THEREFORE after careful consideration of the matter sanction of ` 12,900/- (Rupees Twelve Thousand Nine Hundred) only is hereby accorded to Shri <incumbent>, <designation> as per rule of WBHS – 08 for the purpose of his medical treatment.
The undersigned will receive the sanctioned amount in this order from Treasury – I Place & disburse the same to Shri <incumbent>, <designation>, for the purpose for which the same is sanctioned.
The charge is debitable to the Head of account “bla bla bla” under demand no. 28, Departmental Code No.: HO during the financial year 2012-2013.
All concerned are being informed accordingly.
Memo No. : Dated :
Copy for information to:
1. The Accountant General, (A & E), West Bengal
2. The Director, abcd
3. Finance (Audit) Department, Medical Cell, Writers' Building (Ground Floor), Kolkata – 1
4. The Treasury Officer, Treasury – I, Place
5. The Assistant Director, Commercial Accounts
6. Service Book Section of this office
7. Bill Section of this office
8. Personal File of the incumbent
9. Sri <incumbent>, <designation>