[Here briefly describe on sample Application for medical allowance issuance to company or department. To get medical issuance as per company policy you need to submit medical bills of on panel hospitals, pharmacies, and doctors.]

Date…

The Managing Director,

Institute Name…

Institute Address…

Subject: Application for Medical Allowance Issuance

Dear Sir,

I am (Name) working as a (Job designation) at (Department and institute name), for 5 years. I am writing to request you for issuance of my medical allowance as per company policy. Last month I was sick and couldn’t attend my office for medical reasons. (show your actual problem). Now I have recovered from sickness and joined back my office from (date). (show your present situation or financial condition). I got all the treatment from a hospital in company’s panel list.

I have attached all the bills from hospitals and pharmacies with this application for clearance of my medical allowance as per company policy. I request you to please issue all medical allowance payment as soon as possible.

Thank You,

Name…

Job Designation…

Contact no…

Signature.