LETTER ID : PQ_CL_LTR_1001

February 4, 2014

Accounts Officer
Shaikh Zayed Hospital
Muslim Town
Lahore
54660
Punjab
Letter No
Issued On
Valid Upto

Dear Accounts Officer

Assalam-o-Alaikum

CL201433869 / GH200900056641
04/02/2014
03/03/2014

Re : Credit Letter - Jamil Ahmad (University Of Management & Technology)

The following Person is covered under Pak-Qatar's Group Health Takaful schemes. You are kindly requested to please extend the best
possible services/treatment and bill to us for reimbursement as per agreement. Details of Covered Member are as follows:Covered Member's Name
Relationship with Employee
Date of Birth / Age
Identification Number

Jamil Ahmad
Self
22-DEC-87 / 26
3630223428723

Participant Name
Employee's Name
Identification Number

University Of Management & Technology

Jamil Ahmad
3630223428723

APPROVED LIMIT FOR CURRENT HOSPITALIZATION

Rs. 240,000
Maximum Room and Board Entitlement : Rs. 4,000 per day
NOTES FOR THE PREFERRED PROVIDER HOSPITAL
BENEFIT NOT COVERED UNDER TAKAFUL SCHEME
1) This letter is valid only for HOSPITALIZATION & DAY CAR SURGERY, if
recommended by the attending Physician, OUT-Patient treatment, through this - Out Patient Treatment
letter is not allowed except MRI & CT Scan.
- Charges for meals, phone, laundry and Similar
Services.
2) The Preferred Provider (hospital) may entertain the fax copy of this letter duly - Mental Illness due to any cause/drug addiction.
attested by the employer,however, the hospital have the right to call for the - Eye glasses, contact lenses, hearing aids &
original in case of any doubt. Hospital should obtain a Pak-Qatar's Identification Dentures.
Card/Photo/National Identity Card Identification of the patient.
- Dental Examination, Extraction & fillings.
- Radial Keratomy & Excimer laser procedures.
3) The Preferred Provider hospital is requested to forward their bills with all - Cosmetic Surgery, General checkups & rest cures.
supporting documents including copy of CNIC, Pak-Qatar's Identification Card - Congenital defects & deformities.
and copy of this credit letter, to us directly for payment.
- Any hospitalization directly or indirectly related to
Pregnancy.
4) Preferred Provider (Hospital) is requested to inform Pak-Qatar Family Takaful
at phone 021-34311747-56 Ext.153 & 167,(Hotline 0331-8223385), within 24
hours of hospitalization of any of the above named Member.
Pak-Qatar Family Takaful Limited., guarantees the payment to the hospitals on its panel for providing the benefit covered to any of the
above mentioned person, during the validity of this letter (see top right).
For Pak-Qatar Family Takaful Limited

Signature:

Employee's Signature :
Employee's CNIC No.

Muhammad Nasir Ali Syed

Assistant General Manager

Employer's Signature & Seal :