New Bill Forms for WBHS 2008

The expenditure incurred by, and to be reimbursed to on account of medical attendance and treatment under the WBHS, 2008 may be drawn in T.R. Form. 68 and 68A.

Government of West Bengal
Finance Department
Audit Branch

No. 10501-F(Y), dated 18.11.2011

NOTIFICATION

In exercise of the power conferred by Clause (3) of Article 166 of the Constitution of India, the Governor is pleased hereby to make the following amendments in the West Bengal Treasury Rules, 2005, as subsequently amended (hereinafter referred to as the said Rules):-

AMENDMENTS

A. In part I of the said Rules,

For Rule 4.107 substitute the following Rule:-

4.107. (1) The expenditure incurred by and to be reimbursed to Government employees or officials on account of medical attendance and treatment may be drawn in T.R. Form No. 24 under the sub-head “Salaries”.

The amount drawn in the bill in T.R. Form No. 24 shall be supported by proper receipts and vouchers in all cases.

(2) The expenditure incurred by, and to be reimbursed to Government employees and officials and to retired Government employees and officials on account of medical attendance and treatment under the West Bengal Health Scheme, 2008 may be drawn in T.R. Form. 68.

The amount drawn in the bill in T.R. Form No. 68 shall be supported by Proper receipts and vouchers in all cases.

(3) Advance sanctioned under the West Bengal Health Scheme, 2008 may be drawn in T.R. Form No. 68A.

B. In Part III of the said Rules:-

After T.R. Form No. 67 insert T.R. Form No. 68 and T.R. Form No. 68A as per enclosed formats.

By order of the Governor,

Sd/- S.K.Paul
Joint Secretary to the
Government of West Bengal.

T.R. Form No. 68(pdf)
T.R. Form No. 68A(pdf)

T.R. FORM NO. 68
[See T.R. 4.107]
Medical charges Reimbursement Bill under W.B. Health Scheme 2008 [Bill for Final]

Deptt Code: ____________
D.D.O. Code: ____________
Sanction No. ______Date _______ Sanctioning Authority: ______
Bill No. ______Date ______ T.V. No. ______ Date ____________
Head of Account Code: ____________
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): _____

Disease Code:

Hospital / Diagnostic Center’s Code
Indoor / Outdoor / Both
Amount (Rs.)
Total Bill Amount (Rs.): _____
Net amount required for payment (in words) Rupees________
In case of Final Bill
Total Claim in Rs._______________
Less Advance (if any) to Rs.______
Vide TV No. _____TV Date _________
Net Amount Payable / Refundable ______
In case of Refund, Rs. _______________
Challan No._________
Challan Date___________
1.    Certified that I have satisfied myself that the amount drawn previously, with the exception of these detailed below (of which the total amount has been refunded by deduction from this bill) have been refunded by deduction from this bill) have been disbursed to the Government employee therin named and then receipts taken in the office copies of the bill or in a separate acquittance roll.
2.    Details of Medical charges Refunded
Section of establishment it and name of incumbent with designation __________
Period_______Amount (Rs.) _______
3.    Certified that Essentiality certificates, receipts, etc are appended.
4.    Certified that no claim for the period mentioned in this bill has been preferred earlier
Allotment Received Rs._______
Progressive expenditure
including this bill Rs.________
Balance available Rs.__________

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