Page 30 - ITA Shinbun 5-2017
P. 30

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                                                                     Documents

                                                     1.Application for medical claim
                                                     2.Original receipt

                                                     3.Medical certificate





                                                                       Signature

                                                      Applicant : Employee
                                                      Approval : TM and Up





                                                                         Period

                                                     Submit a  form within 60 days from
                                                     the date of completion of the medical
                                                     treatment



                                                                        Pay Date

                                                      End of Month
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