Form for claiming confinement expenses under 56A in ESIC

Hi Seniors,
Greetings,
can anybody help me out with the ESIC form for claiming the confinement expense form under rule-56A.
regards,
Gopikrishna.Ch

SIR
I WANT claiming the confinement expense form under rule-56A. PDF FORMATE
PLEASE SEND TO MY MAIL IN PDF FORMAT

SIR
I WANT claiming the confinement expense form under rule-56A. PDF FORMATE
PLEASE SEND TO MY MAIL IN PDF FORMAT

Dear Friend,
Confinement Expenses is lump sum payment made to an insured woman or an insured person in
respect of his wife if the confinement occurs at a place where necessary facilities under the ESI
Scheme are not available. At present the confinement expenses paid is Rs. 5000/- w.e.f. 1.10.2013
per confinement. It is admissible for two confinements only.