Get Medical 97 Form

Filling out the Medical 97 Form online is essential for government servants seeking reimbursement for medical expenses incurred by themselves or their families. This guide provides step-by-step instructions to help users complete the form accurately and efficiently.

Follow the steps to complete the Medical 97 Form online.

1. Press the ‘Get Form’ button to access the Medical 97 Form and open it in your preferred editor.
2. Begin by entering the name and designation of the government servant in block letters. Indicate whether they are married or unmarried, and if married, the place of employment for their partner.
3. Fill in the office where the government servant is employed and state their pay, along with any other emoluments clearly separated.
4. Provide the place of duty and the actual residential address of the government servant.
5. Enter the name of the patient along with their relationship to the government servant. For children, include their age.
6. Specify the location where the patient fell ill and proceed to itemize the amount being claimed.
7. Detail medical attendance costs by specifying consultation fees, including the name and designation of the medical officer, along with the hospital or dispensary affiliation. Include the dates of consultation and fees.
8. List any pathological, bacteriological, or radiological tests undertaken with details of the hospital or laboratory where they were conducted. Ensure to attach any necessary certificates.
9. Document the cost of medicines purchased, attaching cash memos and essentiality certificates as required.
10. Mention details of hospital treatment, including the hospital's name, accommodation charges, diet, surgical operations, and other relevant expenses also attaching required certificates.
11. Provide consultation details with specialists if applicable, ensuring all necessary certificates are attached.
12. Calculate the total amount claimed and subtract any advance taken to indicate the net amount being claimed.
13. Compile and attach a list of enclosures that support the claims being made.
14. Sign the declaration confirming the truthfulness of the application and the dependency of the person for whom expenses were incurred.
15. Final actions include saving changes, downloading, printing, or sharing the form as necessary.

Complete your Medical 97 Form online today to ensure timely reimbursement for medical expenses.