BLOSSOM MULTI SPECIALITY HOSPITALS AND DAYCARE CEN

Statement Generated By :- 33237

Joint Holder :- NO 1023 CHANNAKESHAVANAGARA
HOSA ROAD
BENGALURU
KARNATAKA
560100

Customer No :847153195
Scheme :CA - BUSINESS CLASSIC
Currency :INR

Statement of Account No :912020064327178 for the period (From : 01-06-2015 To : 30-06-2015)

Tran Date

Chq No

Particulars

01-06-2015

72134

OPENING BALANCE
BRN-CLG-CHQ PAID TO RAVI
RAMACHANDRA

01-06-2015

72138

BRN-CLG-CHQ PAID TO SHAHEENA

01-06-2015

BRN-BY CASH KUMARA SWAMY

01-06-2015

EDC/00222-00223-/M037044015060035

01-06-2015

ECS/TP Religare#2142586726#4009117

01-06-2015

ECS/TP India Infolin#2142586725#4009117

ECS/BAJAJ FINANCE
LI/404FDL05895192/404FDL05895192

02-06-2015
02-06-2015

72139

BRN-CLG-CHQ PAID TO RAVI KUMAR V

02-06-2015

72246

BRN-TO CASH SATHISH N C

02-06-2015
02-06-2015

72140

132008

03-06-2015
03-06-2015
04-06-2015
04-06-2015
04-06-2015
04-06-2015

BRN-CLG-CHQ PAID TO RAVI KUMAR V

481611.52 2568

54000.00

427611.52 2568

72141

229520.00

657131.52 1506

3700.22

660831.74 100

122758.00

538073.74 1028

68020.00

470053.74 1028

106827.00

363226.74 002

45000.00

318226.74 2568

9850.00

308376.74 1506
6099.89

69412.00

314476.63 100
245064.63 2568

By Clg 132008 VJB BANGALORE

26243.00

367207.63 2568

BRN-BY CASH KUMARA SWAMY

NEFT/CITIN15549475532/MEDI ASSIST IND
TPA PVT LTD
ECS/2142708543/TXJF13269/IIL INDUSIND
BANK B
MOB/TPFT/CHANDAN
DASH/912010061988630
ECS/2142759622/0001065737628/TP Fullerton
India

89825.00

457032.63 1506

12637.00

469669.63 248

INB/IFT/CHANDAN DASH/Tds

05-06-2015

53541.00

340964.63 1506

05-06-2015
05-06-2015

Init.
Br

95900.00

04-06-2015

04-06-2015

Balance

BRN-BY CASH KUMARA SWMAY

EDC/00226-00226-/M037044015060035
INB/15098961/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15097768/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15095382/CBDT-ePayment TDS/TCS (/
BWY0000000

04-06-2015

Credit

535152.52

EDC/00059-00225-/M037044015060035

02-06-2015
02-06-2015

Debit

125415.00

344254.63 002
500000.00

78352.00

844254.63 1506
765902.63 002

1314.67

767217.30 100

207976.00

559241.30 1506

234670.00

324571.30 1506

199097.00

125474.30 1506
200000.00

325474.30 1506

BRN-CLG-CHQ PAID TO PRAVEEN B

61200.00

264274.30 2568

ECS/2142947813/21355/Edelweiss Ret Fin

73691.00

190583.30 002

05-06-2015

EDC/00227-00228-/M037044015060035

05-06-2015

05-06-2015

BRN-BY CASH KUMARA SWAMY

NEFT/BKIDN15156591224/MDINDIA
HEALTHCARE SERVICES/
NEFT/150605i64814601/SPURTHI MEDITECH
TPA SOLUTION

05-06-2015

BULKCAPITALFIRSTAXISDDT

54606.00

411544.74 274

90000.00

321544.74 1506

05-06-2015

TO TRIVENI M P
Core banking/CB0000329249/11210289/Blossom
Multis

06-06-2015

BRN-BY CASH KUMARA SWAMY

05-06-2015

05-06-2015

06-06-2015

72124

72142

08-06-2015
08-06-2015

72135

CHANDAN DASH
ECS/2143112713/0001068364629/TPAMAGMA
EMI
BRN-CLG-CHQ PAID TO SWAPNA B

08-06-2015

EDC/00229-00230-/M037044015060035

08-06-2015

EDC/00358-00358-/M037044015060036
MOB/TPFT/CHANDAN
DASH/912010061988630
INB/15176025/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15176702/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15179461/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15177690/CBDT-ePayment TDS/TCS (/
BWY0000000

08-06-2015
08-06-2015
08-06-2015
08-06-2015
08-06-2015
08-06-2015

INB/15177893/ESIC(BILLDESK)/
INB/15179063/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15177589/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15176231/CBDT-ePayment TDS/TCS (/
BWY0000000

08-06-2015
08-06-2015
08-06-2015
09-06-2015

72113

09-06-2015
09-06-2015

EDC/00359-00359-/M037044015060036
EDC/00060-00231-/M037044015060035
ECS/2143345519/0001069804493/TP JFS ECS
DBT

10-06-2015
10-06-2015

INB/IFT/HARISH KUMAR N/Fees for may

IMPS/P2A/516109558584/30703293187SBIN000
7631/con

10-06-2015
10-06-2015
10-06-2015

72183

10-06-2015

EDC/00232-00233-/M037044015060035
BRN-CLG-CHQ PAID TO PRAKASH L
SACHDEV HUF

10-06-2015
72145

BRN-CLG-CHQ PAID TO SHEKARREDDYV

212537.74 100

245122.00

457659.74 1506

1075.00

458734.74 127

7416.00

466150.74 248

4652.00

326196.74 102

97140.00

423336.74 1506

9000.00

414336.74 1506

36877.00

377459.74 002

3690.00

373769.74 2568
7325.23

381094.97 100

10056.93

391151.90 100

500000.00

891151.90 1506

32488.00

858663.90 1506

45400.00

813263.90 1506

44800.00

768463.90 1506

5430.00

763033.90 1506

52459.00

710574.90 1506

6516.00

704058.90 1506

5538.00

698520.90 1506

14204.00

684316.90 1506

2047.00

682269.90 2568
2488.95
859.58

684758.85 100
685618.43 100

97270.00

588348.43 002

67000.00

521348.43 1506

23005.62

498342.81 1506
2393.31

70000.00

EDC/00360-00360-/M037044015060036
NEFT/CITIN15551624188/MEDI ASSIST IND
TPA PVT LTD
ICONN.REF/15177893/BILLDESK
CORP/DT.2015.06.08

10-06-2015

11-06-2015

BRN-CLG-CHQ PAID TO CHAYA C S

21954.44

18000.00

500736.12 100
430736.12 2568

2884.73

433620.85 100

5677.00

439297.85 1028

52459.00

491756.85 100
473756.85 2568

Core banking/CB0000357079/10843629/Blossom
Multis
IMPS/P2A/516213688246/32156945493SBIN001
1285/own
IMPS/P2A/516213688342/32156945493SBIN001
1285/own
INB/15189967/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15191550/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15190155/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15191163/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15185922/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15189968/CBDT-ePayment TDS/TCS (/
BWY0000000

11-06-2015
11-06-2015
11-06-2015
11-06-2015
11-06-2015
11-06-2015
11-06-2015
11-06-2015
11-06-2015
11-06-2015
12-06-2015

72146

12-06-2015

72066

YOURSELF FOR SALARY

EDC/00361-00361-/M037044015060036
BRN-CLG-CHQ PAID TO UMESH ELECTRO
MARKETIX

12-06-2015

36153.00

509909.85 102

200016.85

309893.00 1506

50005.62

259887.38 1506

2260.00

257627.38 1506

2891.00

254736.38 1506

4879.00

249857.38 1506

4200.00

245657.38 1506

5375.00

240282.38 1506

4496.00

235786.38 1506

36060.00
247.86
50000.00

199726.38 1506
199974.24 100
149974.24 2568

12-06-2015

EDC/00234-00235-/M037044015060035
NEFT/CITIN15552299453/MEDI ASSIST IND
TPA PVT LTD

2159.64

152133.88 100

243000.00

395133.88 248

12-06-2015

INB/15196796/ESIC(BILLDESK)/

52459.00

342674.88 1506

12-06-2015

72144

BRN-TO CASH AMBARISH

16750.00

325924.88 677

12-06-2015

72097

BRN-CLG-CHQ PAID TO TO CLEARING

73893.00

252031.88 1946

13-06-2015

73 By Clg 000073 LVB BANGALORE

600000.00

852031.88 2568

13-06-2015

159179

By Clg 159179 SBP BANGALORE

600000.00

1452031.88 2568

13-06-2015

632122

600000.00

2052031.88 2568

15-06-2015

By Clg 632122 PNB BANGALORE

INB/15206150/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15205875/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15204000/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15206252/CBDT-ePayment TDS/TCS (/
BWY0000000
INB/15203525/CBDT-ePayment TDS/TCS (/
BWY0000000

15-06-2015

BRN-BY CASH KUMARASWAMY

15-06-2015
15-06-2015
15-06-2015
15-06-2015

43000.00

2009031.88 1506

43600.00

1965431.88 1506

325481.00

1639950.88 1506

257088.00

1382862.88 1506

277116.00

1105746.88 1506
217190.00

1322936.88 1506

15-06-2015

060942

BY CHEQUE 000460-060942 TO DEE

250200.00

1072736.88 1506

15-06-2015

072248

BY CHEQUE 000460-072248 TO SOU

136593.00

936143.88 1506

15-06-2015

060951

BY CHEQUE 000460-060951 TO ARU

305842.00

630301.88 1506

15-06-2015

060937

BY CHEQUE 000460-060937 TO CHA

83977.00

546324.88 1506

15-06-2015

060938

BY CHEQUE 000460-060938 TO CHA

42442.00

503882.88 1506

15-06-2015

060936

BY CHEQUE 000460-060936 TO CHA

IMPS/P2A/516700080592/1605283000000034KV
BL000160
BRN-CLG-CHQ PAID TO 0HARI GOBINDH
SETH

161468.00

342414.88 1506

50005.62

292409.26 1506

45000.00

247409.26 2568

15-06-2015
16-06-2015

73329

16-06-2015

73328

BRN-CLG-CHQ PAID TO SATISH P

KHEMCHANDANI HUF

73327

EDC/00060-00363-/M037044015060036
BRN-CLG-CHQ PAID TO UMESH ELECTRO
MARKETIX

16-06-2015
17-06-2015
17-06-2015
17-06-2015
17-06-2015
17-06-2015
18-06-2015

78000.00

169409.26 2568
2281.79

78000.00

171691.05 100
93691.05 2568

BRN-BY CASH KUMARA SWAMY

NEFT/156H331231KB1O51/NIC MEDIASSIST
INDIA TPA P
NEFT/CMS314960874/MEDI ASSIST INDIA
TPA PVT LTD/ME

86880.00

180571.05 1506

12888.00

193459.05 002

46170.00

239629.05 248

INB/IFT/CHANDAN DASH/Loan
IMPS/P2A/516910285425/2811510518KKBK000
0433/own

200000.00

439629.05 1506

200016.85

239612.20 1506

18-06-2015

72059

BRN-CLG-CHQ PAID TO SHIVA KUMAR V

666.00

238946.20 2568

18-06-2015

72058

522.00

238424.20 2568

18-06-2015

BRN-CLG-CHQ PAID TO SHIVA KUMAR V

NEFT/MAHBH15169439286/SYMBIOSIS
CENTRE OF HEALTHCA

19-06-2015

EDC/00364-00364-/M037044015060036

19-06-2015

INB/IFT/DEEPTHI P KAMBI/

35564.00

246785.43 1506

35564.00

273988.20 002

8361.23

282349.43 100

20-06-2015

73331

BRN-CLG-CHQ PAID TO MANJUNATHA K P

29502.00

217283.43 2568

20-06-2015

73337

BRN-CLG-CHQ PAID TO SANCHITA SAHA

71395.00

145888.43 2568

22-06-2015

73339

BRN-CLG-CHQ PAID TO RAVI KUMAR V

45000.00

100888.43 2568

60912

EDC/00061-00365-/M037044015060036
NEFT/SIN02763Q0039066/SOBHA
DEVELOPERS LTD//ACC/1
BRN-CLG-CHQ PAID TO SAHU MEDICAL
SYS

22-06-2015
22-06-2015
23-06-2015
23-06-2015
23-06-2015
23-06-2015

EDC/00366-00366-/M037044015060036
60314037-May'15-EDC Late Settle Fee
NACH_DR_Verf_ChgsMAY-15
NEFT/SIN00744Q0036194/TIMKEN
ENGINEERING A

23-06-2015
24-06-2015

7950.10

108838.53 100

68662.00

177500.53 002

63000.00

114500.53 2568
42067.90

156568.43 100
155713.43 100
155613.43 274

19800.00

175413.43 248

4977.90

180391.33 100

1946370.00

2126761.33 1863

855.00
100.00

24-06-2015

EDC/00367-00367-/M037044015060036
RTGS/HDFCR52015062464792982/HDFCBANK
LTD
BRN-CLG-CHQ PAID TO GNANESH
SRINIVAS SHETTY
INB/IFT/CHAITRA CHAITRA
HARS/Consultation

24-06-2015

INB/IFT/SOUMYA R SHETTY/Timken

19800.00

2006044.33 1506

24-06-2015

INB/IFT/DILIP R THOVINAKERE/Consultation

75000.00

1931044.33 1506

24-06-2015

INB/IFT/CHANDAN DASH/Consultation

67500.00

1863544.33 1506

24-06-2015

INB/IFT/ARUN KUMAR/Consultation

67500.00

1796044.33 1506

24-06-2015

INB/IFT/CHANDAN DASH/
INB/NEFT/AXIC151756594640/nexus
medical/equipment

200000.00

1596044.33 1506

50000.00

1546044.33 455

DR ANURADHA VINOD
BRN-CLG-CHQ PAID TO DR RUTH
ADLAKHA

22680.00

1523364.33 009

31374.00

1491990.33 2568

24-06-2015
24-06-2015

73334

24-06-2015
24-06-2015

73330

25-06-2015

73332

28917.00

2097844.33 2568

72000.00

2025844.33 1506

25-06-2015

73336

25-06-2015

BRN-CLG-CHQ PAID TO SHIVA KUMAR V

9787.00

EDC/00368-00368-/M037044015060036

1482203.33 2568
3074.55

1485277.88 100

25-06-2015

072125

BY CHEQUE 000460-072125 TO TRI

90000.00

1395277.88 1506

25-06-2015

060946

BY CHEQUE 000460-060946 TO LIN

68575.00

1326702.88 1506

25-06-2015

072129

BY CHEQUE 000460-072129 TO PRA

123230.00

1203472.88 1506

25-06-2015

73349

150000.00

1053472.88 1506

26-06-2015

60913

BRN-TO CASH SELF

BRN-CLG-CHQ PAID TO SAHU MEDICAL
SYS
INB/15257878/CBDT-ePayment TDS/TCS (/
BWY0000000

63000.00

990472.88 2568

40000.00

950472.88 1506

58530.00

891942.88 1506

500000.00

391942.88 168

76914.00

315028.88 2568

BRN-CLG-CHQ PAID TO DR SHAHEENA

NEFT/150626377GN00089/BOSCH
AUTOMOTIVE ELECTRO

54000.00

261028.88 2568

90000.00

29-06-2015

TO TRIVENI NM P
NEFT/SIN00043Q3964151/BAJAJ ALLIANZ
GENERA

29-06-2015

BRN-BY CASH KUMARA SWAMY

30-06-2015

EDC/00369-00369-/M037044015060036
RTGS/KKBKR52015063000820597/BLOSSOM
MULTI SPECIALI

26-06-2015
26-06-2015
26-06-2015
27-06-2015

73338

27-06-2015

73348

27-06-2015
27-06-2015

30-06-2015

72126

INB/15256595/ESIC(BILLDESK)/
INB/NEFT/AXIC151776799811/blossom
multispeci/own
BRN-CLG-CHQ PAID TO RAVI
RAMACHANDRA

TRANSACTION TOTAL

78458.96

7274665.56

CLOSING BALANCE

339487.84 248
249487.84 785

13378.00

262865.84 248

277960.00

540825.84 1506

6371.11

547196.95 100

500000.00

1047196.95 637

7786709.99

1047196.95

Unless the constituent notifies the bank immediately of any discrepancy found by him/her in this statement of Account, it will be taken that
he/she has found the account correct.
The closing balance as shown/displayed includes not only the credit balance and / or overdraft limit, but also funds which are under clearing. It
excludes the amount marked as lien, if any. Hence the closing balance displayed may not be the effective available balance. For any further
clarifications, please contact the Branch.
We would like to reiterate that, as a policy, Axis Bank does not ask you to part with/disclose/revalidate of your iConnect passord,login id and
debit card number through emails OR phone call Further,we would like to reiterate that Axis Bank shall not be liable for any losses arising
from you sharing/disclosing of your login id, password and debit card number to anyone. Please co-operate by forwarding all such
suspicious/spam emails, if received by you, to customer.service@axisbank.com
REGISTERED OFFICE - AXIS BANK LTD,TRISHUL,Opp. Samartheswar Temple, Near Law Garden, Ellisbridge, Ahmedabad .
380006.This is a system generated output and requires no signature.
Legends :
ICONN-Transaction trough Internet Banking
VMT-ICON-Visa Money Transfer through Internet Banking
AUTOSWEEP-Transfer to linked fixed deposit
REV SWEEP-Interest on Linked fixed Deposit
SWEEP TRF-Transfer from Linked Fixed Deposit / Account
VMT-Visa Money Transfer through ATM
CWDR-Cash Withdrawal through ATM
PUR-POS purchase
TIP/ SCG-Surcharge on usage of debit card at pumps/railway ticket purchase or hotel tips
RATE.DIFF-Difference in rates on usage of card internationally
CLG-Cheque Clearing Transaction

EDC-Credit transaction through EDC Machine

SETU -Seamless electronic fund transfer through AXIS Bank
Int.pd-Interest paid to customer
Int.Coll-Interest collected from the customer

++++ End of Statement ++++