| Name | Description | Type | Additional information |
|---|---|---|---|
| enrolleeNo | string |
None. |
|
| hospitalname | string |
None. |
|
| hospitalAddress | string |
None. |
|
| date_dd_MM_yyyy | string |
None. |
|
| amount | decimal number |
None. |
|
| providerType | string |
None. |
|
| BankName | string |
None. |
|
| accountNo | string |
None. |
|
| documents | Collection of documentUploadRequest |
None. |