Users can access forms for cghs cards for pensioners, cghs cards for serving, medical reimbursement claim form, application form for cghs plastic card, etc. Eligible serving employeespensioners have to apply in the prescribed form. Eligible serving employeespensioners have to apply in the prescribed form available on cghs website. Cghs forms in excel word format click the form to download. The following list of forms is available on cghs website. Click print cghs card a message will appear on the screen requesting to take a coloured printout and get the card laminated. Form mrc s for serving employees central government health scheme medical reimbursement claim form to be filled up by the principal card holder in block letiers 1.
Forms can be downloaded from cghs website or can be taken from office of. Government employees or pensioners can apply for cghs plastic card by filling an online form. Plastic cards for cghs beneficiaries already enrolled and have not applied for plastic cards. Read this article to know complete details about plastic cards, application procedure and steps to check card status online. A serving employee on marriage or on the birth of his her child may get the names of spouse child added to the card after submitting the form for addition duly endorsed by his department. Looking for information on the central government health scheme. Online transfer of cghs cards from one city to another cghs covered city. Eligible serving employeespensioners have to apply online or in the prescribed form. The cghs card holder must surrender the card to the concerned department if heshe is shifting to a non cghs covered area. Please note that you can fill the excel word format form before printing for your onward submission which is free from cuttings overwriting. Cghs beneficiaries without plastic card can also apply for the plastic card. Central government health scheme cghs list of cghs forms. Duplicate cghs card can be obtained against lost card by applying for the same to.
Form of letter to the chief administrative medical authority for medical examination in connection with the commutation of pension form 3. The undersigned is directed to refer to this ministrys o. Cghs contribution may be mentioned in the salary certificate. How to check cghs card status online india study channel. Form to be used by the medical board when reporting on injuries diseasedeath.
Application for renewal of plastic card pensioners mandate form for individuals. Download application form of renewal of cghs plastic card for serving employees. Central government health scheme gghs plastic card. Apply online for central government health scheme plastic card. If i fail to intimate and if the cghs comes to know of the change then the cghs facility is liable to be withdrawn by the cghs and the cghs andor appropriate. Application for renewal of plastic card pensioners.
Application forms available for download for plastic card. Site design and hosting support by national informatics centre, kerala state centre. Requisition for pensioners cghs card s shall be accompanied by three copies of recent 3 x 5 cm size individual photographs of all family members of the retiring employee, one set of which shall be pasted on the application form and shall be attested by a gazetted officer in charge of administration other than cghs. Cghs application for new plastic card in fillable pdf. Ministry of health and family welfare, government of india had started central government health. A message will appear on the screen requesting to take a coloured printout and get the card laminated. Click print card for the beneficiary whose card needs to be printed.
To download the cghs application form follows the below link and you can. The form should be completely filled up with individual photographs pasted as specified in the form download the form here following documents need to be attached. Apply online for central government health scheme plastic. Medical formscertificate, cghs card form pensioners portal. Procedure to get a cghs plastic card cg staff news, 7th. Download the application form for loss of card from official website along with two recent photographs of. We are looking for a doctor with mbbs preferebly md medicine for contractual appointment. Get the info on medical reimbursement form, cghs plastic card, ministry of health and family welfare, cghs login. After downloading the card in pdf format beneficiary can take a colour print.
One can apply for a life time card by paying 10 years contribution together or one can apply for one year, two years etc. Forms can be downloaded from cghs website or can be taken from office of ad jd of city. Disp type card no benid print date beneficiary name mobile no addres signature 1. Certificate of necessity for bipap and bilevel ventilatory support. The plastic cards are available after one month of the application at the parent wellness centre of the card holder. In most of the scheme, the central government is having a stake from 70% to 100%. Application form for new cghs plastic cards this form is used to apply for a plastic card that is mandatory while availing medical services at the empanelled hospitals. Cghs rates easy search package rates for treatments procedures and investigations. Apply for new cghs plastic cards through online central.
Central government new employees or pensioners can apply online for central government health scheme cghs plastic card. Contribution for life time cghs card for pensioners. Add or delete name in cghs card with new simple process. If i fail to intimate and if the cghs comes to know of the change then the cghs facility is. In a major relief to lakhs of central government health scheme cghs beneficiaries, the govt. Form a application for cghs card for serving employees of central government. I undertake to surrender the cghs cards on ceasing to be eligible for cghs benefits. One get a cghs card made from the office of ad jd of the city. Online transfer of cghs cards from one city to another. Download application form of renewal of cghs plastic card for pensioners. Application for new plastic card in fillable pdf about forms compiled in pdf fillable as excel word format these forms retain the original format of the form.
Cghs card for central government pensioners contribution as above depending on the last grade pay at the time of retirement. Apply for new cghs plastic cards through online on. Enter the one time passwordotp sent on registered mobile. Application for cghs card applying for new cghs card in case of new pensioners card cghs card no. Download application form of renewal of cghs plastic card. Along with the form, serving employees need to attach residence proof of self and dependents, age proof of children, and disability certificate of.
Forms for central government health scheme beneficiaries. If i fail to intimate and if the cghs comes to know of the change then the cghs facility is liable to be withdrawn by the cghs and the cghs and or appropriate. Surrender certificate of cghs card while in service. How to apply for cghs plastic card central government. Cghs beneficiaries without plastic card can also apply for the. If i fail to intimate and if the cghs comes to know of the change then the cghs facility is liable to be withdrawn by the cghs and the cghs and or appropriate authority will be free to initiate any action against me. Application form to enroll central government pensioners for central government health scheme also read admin forms apar for various cadres in kendriya vidyalaya may 5, 2011 admin forms application form for withdrawal from tier ii nps account mar 9, 2011 click the following link to download the form download application form for pensioners cghs card. A provision is there to fill up data on application form available online.
Click the below link to download the application form. Form b application for cghs card for pensioners of central. How to apply for cghs plastic card importance of cghs card. Cghs plastic cards were introduced in september, 2008 in delhi ncr and the cards were initially issued with. Health benefits card will be provided by government and save deposited of the same is the responsibility of the employee, to add the names of family members in cghs plastic card, employee should fill their details filled in application form with attached photo, where the name of family member to be added must be as per government id proof attached for reference. Enter the one time password otp sent on registered mobile. Application form for renewal of cghs card serving employees. Click ok download or open the cghs card in pdf format. Get downloadable forms for beneficiaries of central government health scheme cghs, ministry of health and family welfare. As soon as the application for cghs card is accepted at the cghs card section, an acknowledgment letter is issued to the applicant mentioning the card number and the ben id of all family members.
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