№ lp_2_1_23497
Administrative application form for reimbursement of medical expenses incurred for medical attendance or hospital treatment of Central Government servants and their dependent family members.
Form Number: MED-97
Issuing Authority: Office of the Principal Director of Audit (Steel), Ranchi
Document Type: Application Form
Subject: Refund of Medical Expenses
Applicable To: Central Government Servants and their families
Scope: Medical attendance and hospital treatment
Sections: Medical Attendance; Hospital Treatment; Declaration; For Official Use Only
Required Attachments: Essentiality Certificate; Cash Memos; Hospital Receipts; Medical Certificates
Declaration: To be signed in full by the Government Servant
Administrative Use: Scrutiny and sanction by Audit Officer and Deputy Director
Requirement: Separate form for each patient
Price: 8 / 10 USD
The file will be delivered to the email address provided at checkout within 12 hours.

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