Government of West Bengal
No. 10501-F(Y), dated 18.11.2011
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):-
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,
Joint Secretary to the
Government of West Bengal.
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): _________________
Hospital / Diagnostic Center’s Code
Indoor / Outdoor / Both
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. ____________________
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.____________________
including this bill Rs.______________________
Balance available Rs._____________________