BLOSSOM MULTI SPECIALITY HOSPITALS AND DAYCARE CEN

Joint Holder :- NO 1023 CHANNAKESHAVANAGARA

HOSA ROAD
BENGALURU

Customer No :847153195

KARNATAKA

Scheme :CA - BUSINESS CLASSIC

PIN560100

Currency :INR
Statement of Axis Account No :912020064327178 for the period (From : 29-08-2015 To : 28-09-2015)

Tran Date

Value Date

Transaction Particulars

Chq No

Amount(in Rs.)

DR/CR

OPENING BALANCE

Balance(in RS.) Branch Name

371750.09

45000.00

DR

326750.09

CCGOI HYDERABAD HYD

TG

EDC/00401-00401-/M037044015060036

16025.96

CR

342776.05

ATM RECONCILATION
CENTRE

NEFT/4440U15243821966/UNITED HEALTHCARE
PA/PHNI151

12202.00

CR

354978.05

RTGS HUB

29-08-2015

29-08-2015

BRN-CLG-CHQ PAID TO RAVI KUMAR V

29-08-2015

29-08-2015

31-08-2015

31-08-2015

73451

31-08-2015

31-08-2015

INB/IFT/CHANDAN DASH/Consultation

67500.00

DR

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
287478.05
RE

31-08-2015

31-08-2015

INB/IFT/ARUN KUMAR/Consultation

67500.00

DR

219978.05

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

31-08-2015

31-08-2015

EDC/00402-00404-/M037044015060036

83281.07

CR

303259.12

ATM RECONCILATION
CENTRE

31-08-2015

31-08-2015

BRN-BY CASH VAIPURI

191680.00

CR

494939.12

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

01-09-2015

01-09-2015

ECS/2147886688/0001095543251/TP India Infoline In

68020.00

DR

426919.12

SHYAMNAGAR [WB]

01-09-2015

01-09-2015

ECS/2147886689/0001095547202/TP Religare

01-09-2015

01-09-2015

EDC/00405-00405-/M037044015060036

01-09-2015

01-09-2015

BRN-CLG-CHQ PAID TO SHIVA KUMAR V

01-09-2015

01-09-2015

BRN-BY CASH KUMARASWAMY

01-09-2015

01-09-2015

NEFT/CMS335879829/MEDI ASSIST INDIA TPA PVT

LTD/ME

01-09-2015

01-09-2015

NEFT/CMS335880367/MEDI ASSIST INDIA TPA PVT

LTD/ME

02-09-2015

02-09-2015

ECS/BAJAJ FINANCE LI/404FDL05895192/404FDL05895192

03-09-2015

03-09-2015

03-09-2015

73457

122758.00

DR

304161.12

KHADAKPADA, KALYAN
[MH]

1192.75

CR

305353.87

ATM RECONCILATION
CENTRE

5985.00

DR

299368.87

CCGOI HYDERABAD HYD

TG

100000.00

CR

399368.87

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

22714.00

CR

422082.87

RTGS HUB

7166.00

CR

429248.87

KHADAKPADA, KALYAN
[MH]

106827.00

DR

322421.87

DATA CENTRE-CHEMBUR

EDC/00406-00406-/M037044015060036

13266.58

CR

335688.45

ATM RECONCILATION
CENTRE

03-09-2015

BRN-BY CASH KUMARASWAMY

48450.00

CR

384138.45

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

04-09-2015

04-09-2015

ECS/2148009476/0001096443595/TP Fullerton India

04-09-2015

04-09-2015

ECS/2148022165/TXJF17765/IIL INDUSIND BANK B

04-09-2015

04-09-2015

EDC/00407-00407-/M037044015060036

04-09-2015

04-09-2015

04-09-2015

78352.00

DR

305786.45

DATA CENTRE-CHEMBUR

125415.00

DR

180371.45

DATA CENTRE-CHEMBUR

44581.53

CR

224952.98

ATM RECONCILATION
CENTRE

BRN-BY CASH KUMARA SWAMY

113330.00

CR

338282.98

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

04-09-2015

NACH-DR- HDFC BANK LIMITED

53645.00

DR

284637.98

CENTRALISED CTS MUM

MH

05-09-2015

05-09-2015

ECS/CAPITAL FIRST LIMITED/127703657/127703657

54606.00

DR

230031.98

DATA CENTRE-CHEMBUR

05-09-2015

05-09-2015

ECS/CAPITAL FIRST LIMITED/133238010/133238010

56311.00

DR

173720.98

DATA CENTRE-CHEMBUR

05-09-2015

05-09-2015

NACH-DR- RETAILASSETDEPTOFRBL

44062.00

DR

129658.98

CENTRALISED CTS MUM

MH

05-09-2015

05-09-2015

NACH-DR- EDELWEISSRETAILFINLT

73691.00

DR

55967.98

CENTRALISED CTS MUM

MH

05-09-2015

05-09-2015

BRN-BY CASH KUMARASWAMY

152465.00

CR

208432.98

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

05-09-2015

05-09-2015

MURALI MOHAN C R

17253.00

DR

191179.98

JAYANAGAR, BANGALORE
[KT]

07-09-2015

07-09-2015

ECS/2148383607/0001098761709/TPAMAGMAEMI

36877.00

DR

154302.98

DATA CENTRE-CHEMBUR

07-09-2015

07-09-2015

ECS/2148383608/0001098761936/TPAMAGMAEMI

41803.00

DR

112499.98

DATA CENTRE-CHEMBUR

73460

07-09-2015

07-09-2015

BRN-CLG-CHQ PAID TO VISHNU VANDANA

73463

26782.00

DR

85717.98

CCGOI HYDERABAD HYD

TG

07-09-2015

07-09-2015

BRN-CLG-CHQ PAID TO VISHNU VANDANA

73469

28890.00

DR

56827.98

CCGOI HYDERABAD HYD

TG

07-09-2015

07-09-2015

EDC/00408-00409-/M037044015060036

33152.35

CR

89980.33

ATM RECONCILATION
CENTRE

07-09-2015

07-09-2015

BRN-BY CASH KUMARASWAMY

300000.00

CR

389980.33

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

07-09-2015

07-09-2015

NEFT/SIN00043Q4080979/BAJAJ ALLIANZ GENERA

9731.00

CR

399711.33

RTGS HUB

07-09-2015

07-09-2015

NEFT/SIN00043Q4080980/BAJAJ ALLIANZ GENERA

14795.00

CR

414506.33

DATA CENTRE-CHEMBUR

08-09-2015

08-09-2015

EDC/00410-00410-/M037044015060036

1162.96

CR

415669.29

ATM RECONCILATION
CENTRE

08-09-2015

08-09-2015

BRN-CLG-CHQ PAID TO DR SHAHEENA

54000.00

DR

361669.29

CCGOI HYDERABAD HYD

TG

73452

08-09-2015

08-09-2015

NEFT/CMS338074059/MEDI ASSIST INDIA TPA PVT

LTD/ME

10194.00

CR

371863.29

SHANTHINAGAR,
BANGALORE [KT]

08-09-2015

08-09-2015

NEFT/CMS338073610/MEDI ASSIST INDIA TPA PVT

LTD/ME

26889.00

CR

398752.29

NEW DELHI SERVICE

BRANCH [DL]

08-09-2015

08-09-2015

NEFT/CMS338064424/MEDI ASSIST INDIA TPA PVT

LTD/ME

8417.00

CR

407169.29

NEW DELHI SERVICE

BRANCH [DL]

08-09-2015

08-09-2015

NEFT/CMS338064243/MEDI ASSIST INDIA TPA PVT

LTD/ME

9000.00

CR

416169.29

RTGS HUB

08-09-2015

NEFT/MAHBH15251387283/SYMBIOSIS CENTRE OF
HEALTHCA

46872.00

CR

463041.29

RTGS HUB
ATM RECONCILATION
CENTRE

08-09-2015
09-09-2015

09-09-2015

EDC/00411-00411-/M037044015060036

34674.53

CR

497715.82

10-09-2015

10-09-2015

ECS/2148692193/0001100762698/TP DHFL_Dewan Hsg Fn

73893.00

DR

423822.82

LUCKNOW [UP]

10-09-2015

10-09-2015

ECS/2148651523/0001100870085/TP JFS ECS DBT

97270.00

DR

326552.82

DATA CENTRE-CHEMBUR

10-09-2015

10-09-2015

EDC/00412-00412-/M037044015060036

1061.85

CR

327614.67

ATM RECONCILATION
CENTRE

10-09-2015

10-09-2015

BRN-CLG-CHQ PAID TO PRAKASH L SACHDEV HUF

72186

70000.00

DR

257614.67

CCGOI HYDERABAD HYD

TG

10-09-2015

10-09-2015

BRN-CLG-CHQ PAID TO DR RUTH ADLAKHA

73462

47281.00

DR

210333.67

CCGOI HYDERABAD HYD

TG

10-09-2015

10-09-2015

BRN-CLG-CHQ PAID TO RAVI KUMAR V

73465

58703.00

DR

151630.67

CCGOI HYDERABAD HYD

TG

10-09-2015

10-09-2015

DR MANJUNATHA K P

73455

25830.00

DR

125800.67

SARJAPUR ROAD BAN KT

10-09-2015

NEFT/SIN02763Q0039559/SOBHA BANGALORE
GENE//ACC/1

33143.00

CR

158943.67

AHMEDABAD [GJ]

10-09-2015
11-09-2015

11-09-2015

EDC/00413-00414-/M037044015060036

11-09-2015

11-09-2015

Core banking/CB0000539830/11469239/Blossom Multis

14-09-2015

14-09-2015

BRN-CLG-CHQ PAID TO UMESH ELECTRO MARKETIX

14-09-2015

14-09-2015

BRN-TO CASH AMBRISH

14-09-2015

14-09-2015

EDC/00415-00416-/M037044015060036

14-09-2015

14-09-2015

BRN-BY CASH KUMARASWAMY

14-09-2015

14-09-2015

YOURSELF SALARY

14-09-2015

14-09-2015

NEFT/CITIN15582878652/GOOD HEALTH TPA SERVICES

LTD

11755.61

CR

170699.28

ATM RECONCILATION
CENTRE

4765.00

CR

175464.28

BANASHANKARI,
BANGALORE [KT]

72069

50000.00

DR

125464.28

CCGOI HYDERABAD HYD

TG

73473

16750.00

DR

108714.28

ELECTRONIC CITY,
BANGALORE [KT]

50149.79

CR

158864.07

ATM RECONCILATION
CENTRE

100000.00

CR

258864.07

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

12668.00

DR

246196.07

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

3446.00

CR

249642.07

SERAMPORE [WB]

76500.00

DR

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
173142.07
RE

60000.00

DR

113142.07

CCGOI HYDERABAD HYD

TG

73475

15-09-2015

15-09-2015

INB/IFT/HARISH KUMAR N/Consultation for aug

15-09-2015

15-09-2015

BRN-CLG-CHQ PAID TO UMESH ELECTRO MARKETIX

15-09-2015

15-09-2015

NEFT/SIN02763Q0039647/SOBHA BANGALORE
GENE//ACC/1

6011.00

CR

119153.07

DATA CENTRE-CHEMBUR

15-09-2015

15-09-2015

NEFT/4440U15258039535/STAR HEALTH AND ALLI/2016 14

12105.00

CR

131258.07

DATA CENTRE-CHEMBUR

15-09-2015

15-09-2015

NEFT/159F704144C90979/UNITED INDIA INSURANCE CO L

7674.00

CR

138932.07

GANGAWATI [KT]

16-09-2015

16-09-2015

NEFT/SIN00744Q0038078/TIMKEN ENGINEERING A

58079.70

CR

197011.77

DATA CENTRE-CHEMBUR

16-09-2015

16-09-2015

BRN-CLG-CHQ PAID TO SATISH P KHEMCHANDANI HUF

73303

60000.00

DR

137011.77

CCGOI HYDERABAD HYD

TG

16-09-2015

16-09-2015

BRN-CLG-CHQ PAID TO HARI GOBINDH SETH

73325

60000.00

DR

77011.77

CCGOI HYDERABAD HYD

TG

16-09-2015

16-09-2015

BRN-CLG-CHQ PAID TO BINNY

80067

17500.00

DR

59511.77

CCGOI HYDERABAD HYD

TG

16-09-2015

16-09-2015

EDC/00417-00417-/M037044015060036

6964.37

CR

66476.14

ATM RECONCILATION
CENTRE

16-09-2015

16-09-2015

NEFT/4440U15259178585/STAR HEALTH AND ALLI/2016 14

18612.00

CR

85088.14

RTGS HUB

73315

142450.00

CR

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
227538.14
RE

SPURTHI MEDITEC/

12107.00

CR

239645.14

16-09-2015

NEFT/4440U15259232784/UNITED HEALTHCARE
PA/PHNI151

10233.00

CR

249878.14

RTGS HUB

17-09-2015

17-09-2015

BRN-CLG-CHQ PAID TO RAMESH DHALOMAL

MANSINGHA

73419

100000.00

DR

149878.14

CCGOI HYDERABAD HYD

TG

17-09-2015

17-09-2015

BRN-CLG-CHQ PAID TO RAVI KUMAR V

73464

58702.00

DR

91176.14

CCGOI HYDERABAD HYD

TG

18-09-2015

18-09-2015

EDC/00418-00419-/M037044015060036

16769.32

CR

107945.46

ATM RECONCILATION
CENTRE

19-09-2015

19-09-2015

INB/IFT/MYNA K/

27000.00

DR

80945.46

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

19-09-2015

19-09-2015

IMPS/P2A/526200742650/00031140147156HDFC0000003/

7005.70

DR

73939.76

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

19-09-2015

19-09-2015

EDC/00420-00420-/M037044015060036

10104.64

CR

84044.40

ATM RECONCILATION
CENTRE

19-09-2015

19-09-2015

BRN-CLG-CHQ PAID TO BINNY Br

20800.00

DR

63244.40

CCGOI HYDERABAD HYD

TG

19-09-2015

19-09-2015

MOB/TPFT/CHANDAN DASH/912010061988630

150000.00

CR

213244.40

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

19-09-2015

19-09-2015

INB/IFT/DILIP R THOVINAKERE/Consultation

67500.00

DR

145744.40

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

19-09-2015

19-09-2015

INB/IFT/SOUMYA R SHETTY/Timken

58079.00

DR

87665.40

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

16-09-2015

16-09-2015

BRN-BY CASH KUMARASWAMY

16-09-2015

16-09-2015

16-09-2015

80078

CENTRALISED COLL &

PYMNT HUB

19-09-2015

19-09-2015

NEFT/MAHBH15262586818/SYMBIOSIS CENTRE OF
HEALTHCA

54873.00

CR

142538.40

573.29

DR

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
141965.11
RE

RTGS HUB

80.26

DR

141884.85

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

100000.00

CR

241884.85

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE
ATM RECONCILATION
CENTRE

19-09-2015

19-09-2015

Consolidated Charges for A/c

19-09-2015

19-09-2015

Service Tax @14.00% on Charge

21-09-2015

21-09-2015

BRN-BY CASH KUMARASWAMY

21-09-2015

21-09-2015

EDC/00421-00422-/M037044015060036

59325.91

CR

301210.76

21-09-2015

21-09-2015

NEFT/159L354145JR1372/UNITED INDIA INSURANCE CO L

38551.00

CR

339761.76

RTGS HUB

270.96

CR

340032.72

ATM RECONCILATION
CENTRE

63000.00

DR

277032.72

CCGOI HYDERABAD HYD

TG

NEFT/159M34152A4Q1376/MEDI ASSIST INDIA TPA

PVTLTD

16119.00

CR

293151.72

DHORAJI [GJ]

22-09-2015

NEFT/SIN02763Q0039672/SOBHA BANGALORE
GENE//ACC/1

54436.00

CR

347587.72

MUNDIAN
KALAN,LUDHIANA [PB]

22-09-2015

NEFT/159M758535DO1C58/UNITED INDIA INSURANCE CO

L

5354.00

CR

352941.72

RTGS HUB

71937.00

DR

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
281004.72
RE

30500.00

DR

250504.72

CCGOI HYDERABAD HYD

TG

100005.70

DR

150499.02

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

104139.00

DR

46360.02

CCGOI HYDERABAD HYD

TG

2124.68

CR

48484.70

ATM RECONCILATION
CENTRE

50000.00

CR

98484.70

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

22-09-2015

22-09-2015

EDC/00423-00424-/M037044015060036

22-09-2015

22-09-2015

BRN-CLG-CHQ PAID TO MINATI SAHU

22-09-2015

22-09-2015

22-09-2015
22-09-2015

60916

22-09-2015

22-09-2015

INB/IFT/CHANDAN DASH/Consultation

23-09-2015

23-09-2015

BRN-CLG-CHQ PAID TO SHREE SHAKTHI SOUHARDHA C

23-09-2015

23-09-2015

IMPS/P2A/526623141633/2811510518KKBK0000433/Own

24-09-2015

24-09-2015

BRN-CLG-CHQ PAID TO SANCHITHA SAHA

24-09-2015

24-09-2015

EDC/00425-00425-/M037044015060036

24-09-2015

24-09-2015

BRN-BY CASH KUMARASWAMY

24-09-2015

24-09-2015

ANURADHA VINOD

49536.00

DR

48948.70

BANGALORE [KT]

24-09-2015

24-09-2015

NEFT/4440U15267950969/RHICL DISBURSEMENT/51111441

10063.80

CR

59012.50

DATA CENTRE-CHEMBUR

24-09-2015

24-09-2015

NEFT/4440U15267991296/THE TATA POWER COM/7605Bloss

12600.00

CR

71612.50

RTGS HUB

28-09-2015

28-09-2015

NEFT/159RI08109HZ0L58/UNITED INDIA INSURANCE CO L

40320.00

CR

111932.50

DATA CENTRE-CHEMBUR

28-09-2015

28-09-2015

BRN-BY CASH KUMARASWAMY

300000.00

CR

411932.50

PREMIUM,4TH BLOCK
KORAMANGALA,BANGALO
RE

28-09-2015

28-09-2015

EDC/00426-00427-/M037044015060036

44183.55

CR

456116.05

ATM RECONCILATION
CENTRE

28-09-2015

28-09-2015

NEFT/4440U15271195372/RHICL DISBURSEMENT/51111441

5715.00

CR

461831.05

RTGS HUB

471702.01

ATM RECONCILATION
CENTRE

28-09-2015

28-09-2015

80080

80079

80066

EDC/00428-00429-/M037044015060036
TRANSACTION TOTAL DR/CR

9870.96

CR

2660529.95/2760481.87

CLOSING BALANCE

471702.01

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

BRN -Branch

AUTOSWEEP - Transfer to linked fixed deposit

LDG -Lodge

REV SWEEP - Interest on Linked fixed Deposit

INB -Internet Banking

SWEEP TRF - Transfer from Linked Fixed Deposit / Account

RLZ -Realise

VMT - Visa Money Transfer through ATM

DLK -Delink

CWDR - Cash Withdrawal through ATM

DHR -Dishonour

PUR - POS purchase

REC -Recovery

TIP/ SCG - Surcharge on usage of debit card at pumps/railway ticket purchase or hotel tips

LN -Loan

RATE.DIFF - Difference in rates on usage of card internationally

HCY -Home Currency Advance

CLG - Cheque Clearing Transaction

TFR -Transfer

VMT-ICON - Visa Money Transfer Via Internet Banking

INT -Interest Run

EDC - Credit transaction through EDC Machine

BKNG -Booking

SETU - Seamless electronic fund transfer through AXIS Bank

CNCL -Cancellation

Int.pd - Interest paid to customer ISSUE -Issuance

ISSUE -Issuance

Int.Coll - Interest collected from the customer

AMEND -Amendment

OW RTN-Outward return

PUR-Purchase

++++ End of Statement ++++