DETAILS OF SUPER SPECIALTY TREATMENT PAYMENT MADE ON 22
To whom
Name of the Period of
Sl. No. treatment Hospital Name
Insured Person Treatment
taken
Global Hospital 1.5.10 to 10.05.10
1 Srikanth Lenka Self
Global lHospital 22.9.10 to 06.10.10
2 K. Bharathi Father
Miot Hospital 29.10.10 to 15.11.10
3 Kamaludeen Self
Miot Hospital 9.11.10 to 18.11.10
4 Jayalakshmi Mother
Miot Hospital 1.11.10 to 10.11.10
5 R. Ramu Mother
Krishnamoorth
Miot Hospital 14.9.10 to 20.9.10
6 y Mother
M. Selvam Global Hospitals 16.11.10 to 17.11.10
7 Mother
K. Rajendiran Global Hospitals 18.11.10 to 20.11.10
8 Wife
9 R. Dhayalane Mother Global Hospitals 20.4.10 to 26.4.10
V. Seenuvasan Global Hospitals 27.10.10 to 31.10.10
10 Daughter
Karthikeyan Global Hospitals 6.10.10 to 13.10.10
11 Mother
Abdul Kadhar Global Hospitals 23.10.10 to 28.10.10
12 Daughter
A. Sivakumar Global Hospitals 13.10.10 to 23.10.10
13 Wife
Rajendran Global Hospitals 13.10.10 to 14.10.10
14 Wife
DETAILS OF SUPER SPECIALTY TREATMENT PAYMENT MAD
To whom
Name of the Period of
Sl. No. treatment Hospital Name
Insured Person Treatment
taken
K.
Miot Hospitals 23.7.10 to 27.7.10
1 Sathiamoorthy Self
2 Murali Self Miot Hospitals 31.7.10 to 7.8.10
3 Palaniraja Self Miot Hospitals 28.7.10 to 5.8.10
4 N. Ganesh Father Global Hospitals 11.6.10 to 24.6.10
5 Lourdumary Self Global Hospitals 4.8.10 to 7.8.10
Lourdumary Global Hospitals 19.11.10 to 20.11.10
6 Self
A. Jayaraj Global Hospitals 10.11.10 to 11.11.10
7 Wife
Lourdumary Global Hospitals 29.10.10 to 30.10.10
8 Self
A. Sivakumar Global Hospitals 1.11.10 to 13.11.10
9 Wife
A. Jayaraj Global Hospitals 11.10.10 to 20.10.10
10 Wife
R. Ravikumar Global Hospitals 27.9.10 to 02.10.10
11 Mother
12 Lourdumary Self Global Hospitals 17.9.10 to 18.9.10
Mathalin Rani Global Hospitals 6.10.10 to 16.10.10
13 Daughter
Bishnu Prasad
Global Hospitals 29.9.10 to 04.10.10
14 Sharma Self
15 Lourdumary Self Global Hospitals 3.3.10 to 15.3.10
Chandrasekara
Global Hospitals 23.6.10 to 23.7.10
16 n Self
17 Govindaraj Mother Global Hospitals 21.9.10 to 25.9.10
18 Arivajagan Self Global Hospitals 29.9.10 to 30.9.10
DETAILS OF SUPER SPECIALTY TREATMENT PAYMENT MADE ON 13
Name of the To whom Period of
Sl. No. Hospital Name
Insured Person treatment taken Treatment
Miot Hospitals 9.10.10 to 11.10.10
1 Palaniraja Self
Miot Hospitals 9.11.10 to 11.11.10
2 Suresh Father
Miot Hospitals 26.10.10 to 8.11.10
3 Senthilkumar Self
Suresh Global Hospitals 26.05.10 to 29.5.10
4 Self
R. Indira Global Hospitals 1.11.10 TO 23.11.10
5 Husband
J. Perumal Global Hospitals 10.12.10 to 13.12.10
6 Self
Lourdumary Global Hospitals 11.12.10 to 13.12.10
7 Self
M. Veerasamy Global Hospitals 22.11.10 to 23.11.10
8 Self
S.
Sathyanarayanan Global Hospitals 5.3.10 to 20.3.10
9 Mother
Bishnu Prasad
Global Hospitals 3.12.10 to 7.12.10
10 Sharma Self
11 Rajendiran Self Global Hospitals 2.12.10 to 3.12.10
Arivajagan Global Hospitals 29.11.10 to 1.12.10
12 Self
N.
Global Hospitals 01.12.10 to 3.12.10
13 Arumougassamy Self
14 A. Jayaraj Wife Global Hospitals 3.12.10 to 4.12.10
T PAYMENT MADE ON 22.12.2010 &27.12.2010
Date of
Despatch to
Name of the Attached
Amount Concerned / Remarks
employer Dispensary
Hospital /
Dispensary
22.12.2010
91,358.00 Sedarapet
127000
Mudaliarpet 22.12.2010
18,150.00
Gandhi Nagar 27.12.2010
18,960.00
Gandhi Nagar 27.12.2010
30,530.00
Mudaliarpet 27.12.2010
Gandhi Nagar 27.12.2010
164,000.00
3,756.00
Thirubhuvanai 27.12.2010
8,931.00
Nedugadu 27.12.2010
15,361.00 Gandhi Nagar 27.12.2010
4,395.00
Villianur 27.12.2010
15,745.00
Thirubhuvanai 27.12.2010
28,275.00
Villianur 27.12.2010
16,672.00
Gandhi Nagar 27.12.2010
5,209.00
Villianur 27.12.2010
ATMENT PAYMENT MADE ON 04.1.2011
Date of
Despatch to
Name of the Attached
Amount Concerned / Remarks
employer Dispensary
Hospital /
Dispensary
04.01.2011
13,351.00 Mudaliarpet
17,580.00 Muthirapalayam 04.01.2011
30,770.00 Gandhi Nagar 04.01.2011
39,958.00 Gandhi Nagar 04.01.2011
16,205.00 Villianur 04.01.2011
14,129.00 Gandhi Nagar 04.01.2011
6,191.00 Thirubhuvanai 04.01.2011
12,626.00 Nedugadu 04.01.2011
32,492.00 Gandhi Nagar 04.01.2011
23,554.00 Villianur 04.01.2011
29,726.00 Thirubhuvanai 04.01.2011
12,388.00 Villianur 04.01.2011
34,666.00 Gandhi Nagar 04.01.2011
Gandhi Nagar 04.01.2011
43,803.00
32,600.00 Villianur 04.01.2011
Mudaliarpet 04.01.2011
317,513.00
30,229.00 Hosur 04.01.2011
2,462.00 Mudaliarpet 04.01.2011
EATMENT PAYMENT MADE ON 13.1.11
Date of Despatch
Name of the Attached to Concerned /
Amount
employer Dispensary Hospital /
Remarks
Dispensary
2,848.00 Gandhi Nagar
13.01.11
19,755.00 Mudaliarpet 13.01.11
122,390.00 Thirubhuvanai 13.01.11
17,917.00 Gandhi Nagar 13.01.11
186,202.00 Puducherry 13.01.11
8,799.00 Ariankuppam 13.01.11
3,391.00 Villianur 13.01.11
7,203.00 Villianur 13.01.11
Mudaliarpet 13.01.11
185,000.00
Gandhi Nagar 13.01.11
17,823.00
7,566.00 Mudaliarpet 13.01.11
6,802.00 Gandhi Nagar 13.01.11
Gandhi Nagar 13.01.11
8,410.00
5,437.00 Muthialpet 13.01.11