Medical Reimbursement (Advance) Form West Bengal

Medical Reimbursement (Advance) Form West Bengal PDF download free from the direct link given below in the page.

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Medical Reimbursement (Advance) Form West Bengal PDF

Medical Reimbursement is an arrangement under which employers reimburse the portion of the health expenses incurred by the employee. The Income Tax Act allows tax exemption of up to INR 15,000 on medical reimbursements paid by the employer.

You can download the West Bengal Health Scheme Reimbursement Form for Pensioners PDF from the link given at the bottom of this article.

Required Details for Medical Reimbursement Form WB

  • Department / Office of
  • Whether Employee (E) / Pensioner (P) / AIS Officer (A):
  • Employee / Pensioner Identification No.
  • Name of the Govt. Employee / Pensioner
  • Identification No. of Beneficiary
  • Treatment Period: From Date (dd/mm/yyyy)
  • To Date of (dd/mm/yyyy)
  • Signature

Download the Medical Reimbursement Advance Form West Bengal in PDF format from the official website from the link given below.

Download Medical Reimbursement (Advance) Form West Bengal PDF

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