Medical Reimbursement, Deceased Mother, Medical Claim, Affidavit, Legal Heirs, Death Certificate, No Objection Certificate, Family Pension, Reimbursement Claim, Claimant Declaration, Medical Expenses, Legal Heir Declaration, Government Medical Claim, Deceased Employee Benefits
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AFFIDAVIT FOR MEDICAL REIMBURSEMENT CLAIM OF DECEASED MOTHER

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AFFIDAVIT FOR MEDICAL REIMBURSEMENT CLAIM OF DECEASED MOTHER
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An affidavit for submitting medical reimbursement claim papers relating to the treatment of a deceased mother and declaring the particulars of other legal heirs who have no objection to payment of the reimbursable amount to the claimant.