Medical Claim
Access your medical claim dashboard
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Medical Claim
Claim Submission Form
Claim List
Medical Claim Submission Form
Claim Number:
TALENTA Date:
Submission Date:
Employee Name:
Relationship As:
Department:
Select Department
HR
IT
Finance
Sales
Technic
Maintenance
Supply Chain
Engineering
Claim Type:
Claimed Amount:
Approved Amount:
Receipt Date:
Notes:
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Claim List
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Claim No.:
TALENTA Date:
Submission Date:
Employee Name:
Relationship As:
Department:
Select Department
HR
IT
Finance
Sales
Technic
Maintenance
Supply Chain
Engineering
Claim Type:
Claimed Amount:
Approved Amount:
Receipt Date:
Notes:
Status:
Pending
Approved
Rejected
Save Changes
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Claim Details