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West Bengal Health Scheme Claim Form by dy2bwn is a document available to read on EtoBox.

What is West Bengal Health Scheme Claim Form about?

This document is a reimbursement claim form for cashless In-Patient Department treatment under the West Bengal Health Scheme submitted by Hasina Begam for Rs. 2509. It includes details about the employee, patient, treating hospital, treatment period, and expenses incurred, along with declarations and required enclosures. The claim is for treatment received at The Mission Hospital and covers both inpatient and related outpatient expenses.

Author

dy2bwn

Language

EN