INDEX

Sr. No. Name of Schedule Schedule No. Page No.

1 Abstract
2 Expenditure Summary (Medical)
3 Income/Expenditure Summary (Admn)
4 Social Security Contribution Target 1
5 Statistics of Registered Establishments and Workers 2
6 Consumption of Medicine 3
7 Stock Position of Medicine upto 31 Dec 2024 4
8 Retainee Fee 5
9 Refund of Contribution 6
10 Summary of Pay & Allowances 7
11 Detail of Pay & Allowances (PPG 1 to 11) 7A
12 Detail of Pay & Allowances (PPG 12 & Above) 7B
13 Detail of Pay & Allowances OSD Posts (PPG 1 to 15) 7C
14 Regular Employees Pension Contribution ( July to Dec. 2024) 7D
15 Detail of Sanctioned Posts 8
16 Shifting of Sanctioned Posts 9
17 New Posts Created by Head Office during the Year 10
18 Total Cost of Liveries to Staff 11
19 Medical Treatment to Staff 12
20 Rent of Building 13
21 Detail of Vehicles 14
22 Expenses on Official Vehicles 15
23 Expenses on Ambulances 16
24 Summary of Survivor & Disablement Pensioners 17
25 List of Medical Outlets 18
26 Telephone Expenses 19
 BUDGET 2025-26
DIRECTORATE _______________________________
A B S T R A C T

APPROVED PERCENTAGE REVISED PERCENTAGE PROPOSED NEW

Sr. No. CONTROL HEAD OF ACCOUNT BUDGET TO TOTAL BUDGET TO TOTAL BUDGET EXPENDITURES
2024-25 INCOME 2024-25 INCOME 2025-26 (2025-26)

1 2 3 4 5 6 7 8
1 INCOME
Social Security
i
Contribution
ii Profit on Investment
iii Other Income
Total
2 REVENUE EXPENSES
i Directorate (Medical )
ii Cash Benefits To Secured
iii Workers
Administrative Expenses
iv Loans To Employees
v Misc. Expenses
vi Statutory Reserves
TOTAL REVENUE EXPENSES
3 CAPITAL EXPENSES
i Directorate Medical

ii Administration Wing
TOTAL:-
REVENUE + CAPITAL
EXP:
NET SURPLUS/(DEFICIT)
DY./ADLL. DIRECTOR(F&A) DIRECTOR (MEDICAL)
ORATE _______________________________
A B S T R A C T

TOTAL
PERCENTAG
BUDGET
E TO TOTAL
2025-26
INCOME
(6+7)

9 10
DIRECTOR
 DIRECTORATE________________

EXPENDITURE SUMMARY (MEDICAL)

Total
Expenses Approved Total Expenses Revised Budget Proposed
Actual Revised Excess/ Proposed
2022-23 Approved Budget
Expenses
Outstanding Expenses Excess/ (Less)
Budget (Less)
2024-25
Budget
Budget 2025-26
Sr.No Sub Head of Accounts (As per Budget 2024-25 Expenses up (Upto Dec- (8-5) Recommended by recommended
(Upto Dec- Demanded (2024-25) demanded
F-16) 2024-25 (Upto Dec- to Dec-2024 2024) (Upto Dec- Head Office by H.O in
2024) 2024-25 (10-4) 2025-26
2024) (6+7) 2024) In Budget Meeting Budget Meeting

1 2 3 4 5 6 7 8 9 10 11 12 13 14
Medical Care Expenses (Dispensaries)

1 Bank Charges

2 Bedding & Linen Expenses

3 Books & Periodicals

4 Consumption of Medicines

5 Cost of Liveries

6 Depreciation

7 Dispensary Contigencies

8 Electric, Water & Gas Charges

9 Expenses On Computer

10 Expenses on Laboratry

11 Expenses on X- Ray Centre

12 Gas Filling Charges

Expense on Lab/Hospitalization
13
out side PESSI
14 Legal Expenses

15 Medical Treatment to Staff

16 Pay & Allowances

17 Petrol For Ambulances

18 Petrol For Official Vehicles

19 Postage Expenses

20 Printing & Stationary

21 Publicity Expenses

Refund Of Contribut. For

22
M.Care
Rehabiliation & Financial
23
Assistance To S. W
Reimbursement of Medical
24
Bills to Sec.Workers
25 Rent of Dispensary
 Total
Expenses Approved Total Expenses Revised Budget Proposed
Actual Revised Excess/ Proposed
2022-23 Approved Budget
Expenses
Outstanding Expenses Excess/ (Less)
Budget (Less)
2024-25
Budget
Budget 2025-26
Sr.No Sub Head of Accounts (As per Budget 2024-25 Expenses up (Upto Dec- (8-5) Recommended by recommended
(Upto Dec- Demanded (2024-25) demanded
F-16) 2024-25 (Upto Dec- to Dec-2024 2024) (Upto Dec- Head Office by H.O in
2024) 2024-25 (10-4) 2025-26
2024) (6+7) 2024) In Budget Meeting Budget Meeting

1 2 3 4 5 6 7 8 9 10 11 12 13 14
26 Repair of PESSI Bulidings

27 R & M of Official Vechicle

28 R & M of Ambulance

29 R & M of Generator

30 R & M of Furniture & Fixture

31 R & M of Medical Equipment

Contingent Budget for Natural

32
Desoster/ Un-Seen Expenditure

33 Retainee Fee

34 Small Medical Appliances

35 Telephone Expenses

36 Travelling Expenses

Treatment To Sec. Worker

37
Abroad
Worker’s Functioning &
38
Gathering
TOTAL
 Total
Expenses Approved Total Expenses Revised Budget Proposed
Actual Revised Excess/ Proposed
2022-23 Approved Budget
Expenses
Outstanding Expenses Excess/ (Less)
Budget (Less)
2024-25
Budget
Budget 2025-26
Sr.No Sub Head of Accounts (As per Budget 2024-25 Expenses up (Upto Dec- (8-5) Recommended by recommended
(Upto Dec- Demanded (2024-25) demanded
F-16) 2024-25 (Upto Dec- to Dec-2024 2024) (Upto Dec- Head Office by H.O in
2024) 2024-25 (10-4) 2025-26
2024) (6+7) 2024) In Budget Meeting Budget Meeting

1 2 3 4 5 6 7 8 9 10 11 12 13 14

FIXED CAPITAL
1 Furniture & Fixture

2 Medical Equipments

TOTAL

GRAND TOTAL

NOTE:
a. Schedule may also be enclosed alphabetically array as per specimen.
b. This information should also be send Head Office through E-mail address as mentined in the budget letter.

ACCOUNTS OFFICER Addl./DY. DIRIECTOR (F&A) DIRECTOR (MEDICAL)

 NAME OF DIRECTORATE________________

INCOME/EXPENDITURE SUMMARY (ADMN)

Sr.No Sub Head of Account Total Approved Approved Actual Outstanding Total Excess/ Revised Excess/ Revised Budget Proposed Proposed
Expenses Budget Budget Expenses Expenses up Expenses (Less) Budget (Less) Recommended budget budget
2023-24 (As 2024-25 2024-25 (Upto Dec- to Dec-2024 (Upto Dec- (8-5) (Upto Demanded (2024-25) by Head Office demanded recommended
per F-16) (Upto Dec- 2024) 2024) Dec-2024) 2024-25 (10-4) in Budget 2025-26 by Head Office
2024) (6+7) Meeting in Budget
Meeting
1 2 3 4 5 6 7 8 9 10 11 12 13 14
Social Security
1
Contribution
2 Profit on Investment
3 Other Income
Total
CASH BENEFITS
SICKNESS BENEFITS.
1 Death Grant.
2 Iddat Benefits.
3 Maternity Benefits.
Sickness Benefits (T. B
4
& Cancer).
5 Sickness Benefits.
Conveyance Charges
6
to Secured Worker
Gross Total.
EMPLOYMENT INJURY
BENEFITS.
1 Disablement Gratuity
2 Disablement Pension
3 Injury Benefits
4 Reserves
5 Survivors Pension
Gross Total.
GRAND TOTAL.
 Sr.No Sub Head of Account Total Approved Approved Actual Outstanding Total Excess/ Revised Excess/ Revised Budget Proposed Proposed
Expenses Budget Budget Expenses Expenses up Expenses (Less) Budget (Less) Recommended budget budget
2023-24 (As 2024-25 2024-25 (Upto Dec- to Dec-2024 (Upto Dec- (8-5) (Upto Demanded (2024-25) by Head Office demanded recommended
per F-16) (Upto Dec- 2024) 2024) Dec-2024) 2024-25 (10-4) in Budget 2025-26 by Head Office
2024) (6+7) Meeting in Budget
Meeting
1 2 3 4 5 6 7 8 9 10 11 12 13 14

ADMN EXPENSES
1 Audit Fee
2 Bank Charges
3 Books & Periodicals
4 Cost Of Liveries
5 Deferred Liabilities
6 Depreciation
Electric, Water & Gas
7
Charges
8 Expenses On Computer.
9 Legal Expenses
Medical Treatment to
10
Staff
11 Office Contigencies
12 Pay & Allowances
Pol & Maint: Of Motor
13
Cycle
14 Pol For Official Vehicles
15 Postage Expenses
16 Printing & Stationary
17 Publicity Expenses
18 Rent Of Building
Repair & Maint. Of
19
Buildings
Repair & Maint. Of
20
Official Vehl:
Repair of Furniture &
21
Fixture
 Sr.No Sub Head of Account Total Approved Approved Actual Outstanding Total Excess/ Revised Excess/ Revised Budget Proposed Proposed
Expenses Budget Budget Expenses Expenses up Expenses (Less) Budget (Less) Recommended budget budget
2023-24 (As 2024-25 2024-25 (Upto Dec- to Dec-2024 (Upto Dec- (8-5) (Upto Demanded (2024-25) by Head Office demanded recommended
per F-16) (Upto Dec- 2024) 2024) Dec-2024) 2024-25 (10-4) in Budget 2025-26 by Head Office
2024) (6+7) Meeting in Budget
Meeting
1 2 3 4 5 6 7 8 9 10 11 12 13 14

Reserves/Contingent
Budget for Natural
22
Disaster/ Un-Seen
Expenditure

23 Telephone Expenses
24 Travelling Expenses
25 I.T. Expenses
Total.
CAPITAL EXPENDITURE (ADMN)
1 Land & Building.
Office Furniture and
2
Fixture.
Official Vehicles/Staff
3
Car.
Total.
GRAND TOTAL

NOTE:
a. schedule may also be enclosed Alphabetically as per specimen.
b. This information should also be send Head Office through E-mail.

ACCOUNTS OFFICER Addl./DY. DIRIECTOR (F&A) DIRECTOR

BUDGET 2025-26
SCHEDULE NO. 1

DIRECTORATE _________________________________________

SOCIAL SECURITY CONTRIBUTION TARGET

Contribution
Excess / (Less) Excess / (Less)
Contribution F-5 F-5 Received / Impact of Upper
Particular F-4 C-4 than Target Liquidity than Liquidity
Target Current Year Previous Year Receivable Wage Limit
(2-7) (2-10)
(3+4+5+6)
1 2 3 4 5 6 7 8 9 10 11
Year 2023-24

Year 2024-25

Year 2024-25
(July-24 to Dec-24)

Liquidity 2024-25
(July-24 to Dec-24)
Revised Target (2024-25)
Proposed Target (2025-26)

Note:- Please Provide copies of EIA Statement and Consolidated C-4 for the Month of Dec, 2024.

ADLL./DY. DIRECTOR(F&A) DY. DIRECTOR (ADMN) DIRECTOR

BUDGET 2025-26
SCHEDULE NO.2
DIRECTORATE _____________________________________

STATISTICS OF REGISTERED ESTABLISHMENTS AND WORKERS

SR. NO . PARTICULARS 2023-24 2024-25

WORKERS

1 No. of Secured Workers as per budget,

Less Workers reduced due to permanent closure of units

2
during the year (Add Documentary evidence).

3 Add: New Secured Workers of registered Units.

4 Net No. of Secured Workers

UNITS

1 Total Registered Units

2 Permanently closed units

3 Temporarily closed units

4 Functioning units.

CONTRIBUTION

1 Contribution received/receivable for the year

2 Liquidity for the year

3 Contribution Target

4 Amount of Liquidity for first 06-months

Amount of F-4 during first Six months of i.e. upto December

5
received in January

6 Amount of C-4 for Six months of (July, to December)

ADLL./DY. DIRECTOR(F&A) DIRECTOR
BUDGET 2025-26
SCHEDULE NO.3
DIRECTORATE _______________________
CONSUMPTION OF MEDICINE.

Actual Expenditure as per F-16 for the year, 2023-24

1

Approved Budget 2024-25

2

HEAD OFFICE SUPPLY

3

a. 80% Quota

b. Medicine Supplied by the Head Office (during 1st Six months)

c. Medicine purchased by Directorate out of 80% quota on behalf of

Head Office.
d. Total purchases against 80%quota.

e. Short supply if any.

4 LOCAL PURCHASES

a. 20% quota for first six month

b. Bulk Prchase of medicine

c. Emergency Purchase.

d. M-20 during first six months (if any)

e. Total purchases out of 20% quota during 1st Six months.

f. Excess / Less if any.

FIRST SIX FIRST SIX

COMPARISON OF STATISTICAL DATA OF DISPENSARIES MONTHS OF MONTHS OF
2023-24 2024-25

Average Monthly OPD (All Medical Units)

1 (Unit wise detail schould be attached separately)

Average Monthly Refer to Hospital

2

Average Monthly X-Ray

3

Average Monthly No. of Lab Tests

4
ADLL./DY. DIRECTOR(F&A) MO CMS (MEDICINES) DIRECTOR (MEDICAL)
BUDGET 2025-26

SCHE
DIRECTORATE ________________________________________

STOCK POSITION OF MEDICINES UPTO 31-12-2024

Medicine supplied by Medicine Stock Available Stock in hand as Value of orders

Opening Stock Local purchase Consumption
Head Office from purchased on (As on on in pipeline
as on out of 20% from July to
01-07-2024 to behalf of 31-12-2024) 31-12-2024 pertaining to first
01-07-2024 quota December, 2024
31-12-2024 Head Office 1+2+3+4 (5-6) six months

1 2 3 4 5 6 7 8

Note: Addl. Director /Dy. Director (F&A) is required to verify the stock from record.

STORE KEEPER ADLL./DY. DIRECTOR(F&A) DIRECTOR (MEDICAL

 SCHEDULE NO.4
ECTORATE ________________________________________

OSITION OF MEDICINES UPTO 31-12-2024

Total value of
Stock as on
31-12-2024
(7+8)

DIRECTOR (MEDICAL)
BUDGET 2025-26
SCHEDULE
DIRECTORATE ____________________________________
RETAINEE FEE

RATE OF REMUNERATIONS P.M

NAME OF RETAINEE DOCTOR (EXCEPT
APPROVED BY THE HEAD
THOSE APPOINTED AGAINST SANCTIONED ADDRESS OF CLINIC ANNUAL AM
OFFICE.
POST).
*

* Please attach the copy of the approval of Head Office.

ADLL./DY. DIRECTOR(F&A) DIRECTOR (M

 SCHEDULE NO. 05
____________________________________
RETAINEE FEE

ANNUAL AMOUNT

DIRECTOR (MEDICAL)
BUDGET 2025-26
SCHEDULE NO.6
DIRECTORATE __________________________

REFUND OF CONTRIBUTION

NO. OF AVERAGE SECURED AVERAGE MONTHLY AVERAGE APPROVED REVISED

NAME OF
WORKERS CONTRIBUTION MONTHLY BUDGET BUDGET
NOTIFIED UNIT
(During First 06 Months) ( First 06 Months) REFUND 2024-25 2024-25

ADDL: DIRECTOR (F&A) DIRECTOR (MEDI

 PROPOSED
BUDGET
2025-26

DIRECTOR (MEDICAL)/DIRECTOR
BUDGET 2025-26
SCHEDULE NO. 07
DIRECTORATE ______________________________
SUMMARY OF PAY & ALLOWANCES

EFFECT OF
ACTUAL REVISED PROPOSED
ACTUAL EXPENDITURE EXPECTED EXPENDITURE ANNUAL EFFECT OF
EXPENDITURE PAY & ALLOWANCES BUDGET BUDGET
DURING FIRST SIX MONTHS FOR REMAINING SIX GROSS PAY INCREMENT FOR LEAVE
DURING DETAIL 2024-25 2025-26
OF 2024-25 MONTHS OF 2024-25 SEVEN MONTHS ENCASHMENT
2023-24 (2+3) (5+6+7)
OF
1 2 3 4 5 6 7 8 9

PPG 1 to 11 (7A Schedule)

PPG 12 to onwards (7B

Schedule)

Note: separate schedule for Medical and Admn Wing may be prepared.

PAY BILL ASSTT. OFFICE SUPT. ACCOUNTS OFFICER ADLL./D.D (F&A) DIRECTOR (MEDICAL)/DIRECTOR
 BUDGET 2025-26
SCHEDULE NO. 7A
DIRECTORATE ______________________________

DETAIL OF PAY & ALLOWANCES

PPG 01 to 11

EFFECT OF
NAME OF PAY NO OF EFFECT OF
BASIC HOUSE CONVEYANCE ---------- GROSS ANNUAL
POST GROUP SANCTION NPA ----------- ----------- LEAVE
PAY RENT ALLOWANCE - PAY INCREMENT
NO. ED POST ENCASHMENT
(07 MONTHS)
1 2 3 4 5 6 7 8 9 10 11 12 13

Amount per month ____________________________

Amount per year ___________________________
Effect of Annual increament ____________________________
Effect of Leave Encashment ____________________________
Total _________________________________

Note: separate schedule for Medical and Admn Wing may be prepared.

ADLL./DY. DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

 BUDGET 2025-26
SCHEDULE NO. 7B
DIRECTORATE ______________________________

DETAIL OF PAY & ALLOWANCES

PPG 12 & Above

CONVEYAN EFFECT OF
NAME OF PAY NO OF EFFECT OF
BASIC HOUSE CE ------------- GROSS ANNUAL
POST GROUP SANCTION NPA ----------- -------------- LEAVE
PAY RENT ALLOWAN - PAY INCREMENT
No. ED POST ENCASHMENT
CE (07 MONTHS)

1 2 3 4 5 6 7 8 9 10 11 12 13

Amount per month ______________________________

Amount per year ______________________________
Effect of annual increment ______________________________
Effect of Leave Encashment ______________________________
Total ______________________________

Note: separate schedule for Medical and Admn Wing may be prepared.

ADLL./DY. DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

 BUDGET 2025-26
SCHEDULE NO. 7C
DIRECTORATE ______________________________

DETAIL OF PAY & ALLOWANCES

OSD POST PPG 1 to 15

BENEFICIARY OFFICE DATE OF

SR. NO. DECEASED PERSON PPG NO.
NAME ORDER NO. SUPERANNUATION
1 2 3 4 5 6

Note: separate schedule for Medical and Admn Wing may be prepared and attach the office order.

ADLL./DY. DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

 BUDGET 2025-26
Schedule : 7D
DIRECTORATE ______________________________

REGULAR EMPLOYEES (PENSION CONTRIBUTION)

JULY 2024 to DECEMBER 24

Pension Contribution @ 33.33% of the Mean

Mean of Min&
Sr. No. Employee's Name Designation PPG/BPS Basic Pay Total
Max of PPG
Jul-24 Aug-24 Sep-24 Oct-24 Nov-24 Dec-24

1 2 3 4 5 6 7 8 9 10 11 12 13

Amount per year _________________________________

Note: Detail of each Employee with name should be provided as per above schedule.

OFFICE SUPT. ADLL./DY. DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

BUDGET 2025-26
SCHE
DIRECTORATE ______________________________

DETAIL OF SANCTIONED POSTS

NO. OF
Name of Office - PPG AS PER WORKING AT
SANCTIONED
Director / Sub PAY APPROVED PRESENT (PPG)
SR. NO NAME OF POSTS POSTS AS PER
Office /Medical GROUP BUDGET (If Different from
APPROVED
Outlets___ 2024-25 Approved Budget)
BUDGET 2024-25
1 2 3 4 5 6 7

Note: Separate list of each unit should be provided

OFFICE SUPERINTENDENT ADLL./DY.DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRE

 SCHEDULE NO. 8
RECTORATE ______________________________

DETAIL OF SANCTIONED POSTS

NO OF VACANT
POSTS

Note: Separate list of each unit should be provided

DIRECTOR (MEDICAL)/DIRECTOR
BUDGET 2025-26

DIRECTORATE ______________________________________ SCHEDULE NO. 9

SHIFTING OF SANCTIONED POSTS

NO OF
SANCTIONED
NO. OF POSTS HEAD OFFICE
PAY POST AS PER
SR. NO NAME OF POSTS SHIFTED DURING SHIFTED FROM SHIFTED TO ORDER NO. &
GROUP APPROVED
2024-25 DATE
BUDGET 2024-
25

1 2 3 4 5 6 7 8

ADLL./DY.DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

BUDGET 2025-26
SCHEDULE NO. 10
DIRECTORATE _______________________________

NEW POSTS CREATED BY HEAD OFFICE DURING THE YEAR

FINANCIAL
NO. OF ALREADY NO. OF NEW IMPLICAATION
NAME OF NEW SECTION /
PAY GROUP SANCTIONED SANCTIONED OF NEW
POST DEPARTMENT
POSTS POSTS SANCTIONED
POSTS

1 2 3 4 5 6

* Please provide the copies of approval of Head Office regarding creation of Posts.

Note: Note: separate schedule for Medical Care (SSD) and Admn Wing may be prepared.

ADLL./DY.DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

BUDGET 2025-26 SCHEDULE NO. 11

DIRECTORATE ______________________________

TOTAL COST OF LIVERIES TO STAFF

COST OF
SR. NO NAME OF EMPLOYEES PPG-NO. DESIGNATION
LIVERIES
1 2 3 4 5

TOTAL

Note: separate schedule for Medical Care (SSD) and

Admn Wing may be prepared.

ADLL./DY. DIR. (F&A) DIRECTOR (MEDICAL)/DIRECTOR

BUDGET 2025-26
Schedule 12
DIRECTORATE ______________________________________
MEDICAL TREATMENT TO STAFF

1 Actual Exps: during the year, 2023-24

2 Approved Budget 2024-25

3 Actual Exps: from July to Dec, 2024

a. Expenses on outdoor patients. (Re-Imbursed) OPD/Test etc.

b. Expenses on Indoor Patients (Re-Imbursed) (Admitted cases)

c. Expenses on Choronic Patient as sanctioned by

the Head office *

Total

4 Estimated Expenses of Next Six Months

5 Revised Budget, 2024-25

6 Proposed Budget, 2025-26

* Please attach the list of Chronic Patients with Expenses Per Month

ADLL./DY.DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

BUDGET 2025-26
SCHEDULE NO. 13
DIRECTORATE ________________________

RENT OF BUILDINGS

ANY
ENHANCEMEN
EXPECTED
MONTHL T IN RENT ENHANCEMENT RENT P.M
ENHANCEMEN
Y RENT DATE OF SANCTIONED PROPOSED BY PAYABLE REVISED PROPOSED
SR. T DURING THE JUSTIFICATION OF
NAME OF UNIT BEING ENHANCEMEN BY THE HEAD DIRECTORATE DURING BUDGET BUDGET
NO YEAR, 2024-25 ENHANCEMENT
PAID T OFFICE IF ANY THE YEAR 2024-25 2025-26
AS PER RENT
2024-25 DURING THE 2024-25
DEED/AGREE
YEAR
MENT

1 2 3 4 5 6 7 8 9 10 11

Note: separate schedule for Medical Care (SSD) and Admn Wing may be prepared.

ADLL./DY.DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

BUDGET 2025-26
SCHEDULE NO. 14
DIRECTORATE __________________________

DETAIL OF VEHICLES.

STATION OF
TYPE OF VEHICLE MAKE i.e TYPE OF FUEL
VEHICLE i.e
i.e STAFF SUZUKI/MAZDA/ USED i.e REGISTRATION
SR.NO. DIRECTORATE/ MODEL PERFORMANCE REMARKS
CAR/AMBULANCE/L MITSUBISHI ETC PETROL/CNG/ NO.
SUB
OADER * DIESEL
DIRECTORATE.

* Please Provide copy of Condemnation declared by the ETO if any vehicle is shown as Comdemn.

Note: separate schedule may be prepared for Dispensaries and Admn Wing

ADLL./DY.DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

BUDGET 2025-26
SCHEDU
DIRECTORATE ______________________________

EXPENSES ON OFFICIAL VEHICLES

PETROL Repair & Maintenan

TYPE OF VEHICLE
S.NO VEHICLE NO. (Staff Car/
Ambulance / Van) Allocated Budget Expenses Upto Dec Allocated Budget
2024-25 2024 2024-25

NOTE: Detail of Existing Vehicles Only (Separate Schedule for Medical and Admn wing)

ADLL./DY.DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR

 SCHEDULE NO. 15
ORATE ______________________________

ENSES ON OFFICIAL VEHICLES

Repair & Maintenance

Expenses Upto Dec

2024

hedule for Medical and Admn wing)

BUDGET 2025-26
SCHEDUL
HOSPITAL ______________________________

EXPENSES ON AMBULANCES

PETROL Repair & Maintenan

TYPE OF VEHICLE
S.NO VEHICLE NO. (Staff Car/
Ambulance / Van) Budget Allocated Expenses Upto Dec Budget Allocated
2024-25 2024 2024-25

NOTE: Detail of Existing Vehicles Only (Separate Schedule for Medical and Admn wing)

ADLL./DY.DIRECTOR (F&A) DIRECTOR/DIRECTOR (MEDICAL)

 SCHEDULE NO. 16
TAL ______________________________

EXPENSES ON AMBULANCES

Repair & Maintenance

Expenses Upto Dec

2024

hedule for Medical and Admn wing)

BUDGET 2025-26
SCHEDULE NO. 17
DIRECTORATE _________________________

SUMMARY OF SURVIVORS PENSIONERS

SR. NO NAME OF SS NO DATE OF PENSION AMOUNT

PENSIONER STARTED

Annual Impact Rs. ___________________

SUMMARY OF DISABLEMENT PENSIONERS

S.NO NAME OF SS NO DATE OF PENSION AMOUNT

PENSIONER STARTED

Annual Impact Rs. ___________________

ADLL./DY.DIR. (F&A) DIRECTOR (MEDICAL)/DIRECTOR

BUDGET 2025-26
SCHEDULE NO. 18
DIRECTORATE _________________________

LIST OF MEDICAL OUTLETS

1 2 3 4 5
Sr. No Name of Functional Name of New Established Name of Dispensery Name of Dispensery
Medical Outlets & Dispenseries During the year Closed During the year upgrade During the year
Adress (if any) alongwith Office Order (if any) alongwith Office (if any) alongwith Office
No & Date Order No & Date Order No & Date

ADLL./DY.DIRECTOR (F&A) DIRECTOR (MEDICAL)

DIRECTOR (MEDICAL)
BUDGET 2025-26
SCHEDULE NO. 19

DIRECTORATE ________________________

TELEPHONE EXPENSES

PER MONTH CEILING

TELEPHONE TOTAL PER
SR. NO NAME OF OFFICE OF INTERNET
NO. ANNUM.
MOBILE/TELEPHONE
1 2 3 4 5 6

TOTAL

ADLL./DY. DIRECTOR (F&A) DIRECTOR (MEDICAL)/DIRECTOR