arogya.maharashtra.gov.in · created date: 9/24/2020 4:24:12 pm

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Page 1: arogya.maharashtra.gov.in · Created Date: 9/24/2020 4:24:12 PM

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Page 2: arogya.maharashtra.gov.in · Created Date: 9/24/2020 4:24:12 PM

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Page 3: arogya.maharashtra.gov.in · Created Date: 9/24/2020 4:24:12 PM

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Page 4: arogya.maharashtra.gov.in · Created Date: 9/24/2020 4:24:12 PM

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Page 5: arogya.maharashtra.gov.in · Created Date: 9/24/2020 4:24:12 PM

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Page 6: arogya.maharashtra.gov.in · Created Date: 9/24/2020 4:24:12 PM

To be submitted on Original Letter head/pad

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Page 7: arogya.maharashtra.gov.in · Created Date: 9/24/2020 4:24:12 PM

To be submitted on Original Letter head/pad

Details of Bank for Payment

1 Name of Firm

2 Postal Address

3 Pin Code

4 Contact Number

5 Name of Bank

6 Bank Address

7 Branch Name

8 Bank Account Number

9 Nature of Account

10 IFSC Code '

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