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BILLNO BILLDT EXPAMT REMARKS MEDICAL EXPENSES 34709 12.04.2009 528 MEDICAL 1381 25.04.2009 624 MEDICAL 2342 31.05.2009 65 MEDICAL 93077 09.05.2009 284 MEDICAL 93134 23.05.2009 177 MEDICAL 36138 23.05.2009 242 MEDICAL 3121 26.05.2009 60 MEDICAL 93171 02.06.2009 231 MEDICAL 90 15.06.2009 168 MEDICAL 35456 04.05.2009 107 MEDICAL 5498 29.04.2009 57 MEDICAL 93637 16.06.2009 284 MEDICAL 3081 23.06.2009 108 MEDICAL 2106 01.07.2009 94 MEDICINE 37565 05.07.2009 411 MEDICINE 3637 08.07.2009 279 MEDICINE 3531 10.07.2009 270 MEDICINE 4032 12.07.2009 244 MEDICINE 88026 19.07.2009 70 MEDICINE 38179 24.07.2009 430 MEDICINE 12194 28.07.2009 418 MEDICINE 23303 30.07.2009 627 MEDICINE 38525 02.08.2009 87 MEDICINE 38819 09.08.2009 199 MEDICINE 38820 09.08.2009 88 MEDICINE 93583 18.08.2009 668 MEDICINE 94005 28.08.2009 576 MEDICINE 94006 28.08.2009 119 MEDICINE 94093 10.09.2009 221 MEDICINE 4530 13.09.2009 43 MEDICINE 1859 30.09.2009 351 MEDICINE 40467 30.09.2009 656 MEDICINE 94534 22.10.2009 386 MEDICINE 94260 09.10.2009 189 MEDICINE 94533 22.10.2009 279 MEDICINE 94348 04.11.2009 81 MEDICINE 42045 01.11.2009 500 MEDICINE 12945 19.11.2009 206 MEDICINE 42529 14.11.2009 657 MEDICINE 43200 02.12.2009 410 MEDICINE 27734 28.11.2009 146 MEDICINE 5050 07.12.2009 239 MEDICINE 5076 09.12.2009 186 MEDICINE 94788 12.12.2009 384 MEDICINE 43776 19.12.2009 387 MEDICINE 95253 25.12.2009 172 MEDICINE 95290 31.12.2009 400 MEDICINE 11439 07.01.2010 3900 RIL HEALTH CHECKUP 95330 09.01.2010 661 MEDICINE I hereby certify that I have incurred following expenses during the period of 01.04.2009 to 31.03.2010 Emp Code: 10012471 Expense Bill Form No.: 960255 Emp Name: Amal Kumar Adhikari Location: Relene-Navi Mumbai Phone No: 02229775608 Payroll Area: BC BecRel Engineering P Ltd BecRel For the Period : 01.04.2009 TO 31.03.2010 11669 11.01.2010 600 CONSULTATION CARDILOGY 11670 11.01.2010 400 MEDICINE 3906 13.01.2010 313 MEDICINE 44710 13.01.2010 330 MEDICINE 98652 13.01.2010 274 MEDICINE 17619 20.01.2010 98 MEDICINE 14936 21.01.2010 134 MEDICINE 7314 23.01.2010 291 MEDICINE 20609 23.01.2010 446 MEDICINE 95363 19.01.2010 446 MEDICINE 23984 08.05.2009 670 PATHOLOGY 23985 08.05.2009 120 PATHOLOGY 1731 02.04.2009 300 CONSULTANCY 1305 19.06.2009 300 CONSULTANCY 8723 30.07.2009 200 CONSULTANCY 8724 30.07.2009 200 CONSULTANCY 1922 25.01.2010 1070 PATHOLOGY 773 25.01.2010 300 CONSULTANCY EYE SPECIALIST Total : 24461 Declaration: I hereby declare that the above expenses are incurred by me on myself /my members of the family on medical treatment. In case any tax liability arises on account of submission of proofs/supporting on the Company, I will be personally responsible and Company will have right to recover those dues from me. Date : 27.01.2010 Signature of Employee Note : 1. Please attach proof in the same order in which it appears above. I hereby certify that I have incurred following expenses during the period of 01.04.2009 to 31.03.2010 Emp Code: 10012471 Expense Bill Form No.: 960255 Emp Name: Amal Kumar Adhikari Location: Relene-Navi Mumbai Phone No: 02229775608 Payroll Area: BC BecRel Engineering P Ltd BecRel For the Period : 01.04.2009 TO 31.03.2010