The undersigned is directed to refer to this ministrys 0. Disp type card no benid print date beneficiary name mobile no addres signature 1. Disp typecard no benid print date beneficiary name mobile no addres signature 1. The undersigned is directed to invite reference to this ministrys o. If i fail to intimate and if the cghs comes to know of. Form to be used by the medical board when reporting on injuries diseasedeath. If the area is coverd under cghs, the card shall remain inoperable until it is accepted by the addl. Gds online recruitment results 2019 out for tamilnadu circle download gds online recruitment results in pdf format by clicking the below l. 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.
If you are a new employee and just had joined the government services in that case you have to select the first option or if you are already having the cghs plastic card here you can apply for the new plastic card. Self attested photocopy of old cghs cards should be attached with the application form. Renewal of cghs plastic cards central government employees news. Cghs plastic cards were introduced in september, 2008 in delhi ncr and the cards were initially issued with. 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. If one or more treatment procedure form part of a major treatment procedure, the package charges would be made against the major procedures and only half of actual charges quoted for minor procedure would be added to the package charges of the first major procedure.
Form a application for cghs card for serving employees of central government. Issue of individual plastic cards to cghs beneficiaries. M no, mise 60242007cghs hqlcghsp dated 30111 december, 2009 wherein guidelines on issue of individual plastic cards to each cells beneficiary serving and rettred were isslled. If in case cghs plastic card is lost or damaged the card holder has to immediately report to ad office, new delhi and department in which the member is working. Issue of individual plastic clllds to cghsbeneficiaries rcgardtng the undersigned is directed to invite reference to this ministrys o. No issuance of cghs card certificate from concerned department in case if card is not issued in previous posting. Apply for new cghs plastic cards through online on. Surrender certificate of cghs card while in service. Selfprinting of cghs card this is with reference to the above. Issue of individual plastic cards to cghs beneficiaries regarding the undersigned is directed to invite reference to this ministrys o.
Tender notice for engagement of agency for making plastic cards for cghs beneficiaries 201820 357 kb. Government employees or pensioners can apply for cghs plastic card by filling an online form. Form bb central government health scheme application form for renewal of cghs card pensioners. Form of letter to the chief administrative medical authority for medical examination in connection with the commutation of pension form 3. The cghs empanelled private hospitals diagnostic centres are requested to provide the medical facilities on the basis of old card upto a maximum period of six months from the date of validity as indicated on the cghs plastic card, subject to the condition that the cghs beneficiary has submitted the application for renewal of cghs plastic card. Issue of plastic cghs card to all existing as well as new cghs beneficiaries regarding. 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. Online transfer of cghs cards from one city to another. Application for cghs card for pensioners of central. Cghs beneficiaries without plastic card can also apply for the plastic card. Central government new employees or pensioners can apply online for central government health scheme cghs plastic card. Apr 01, 2016 click print cghs card a message will appear on the screen requesting to take a coloured printout and get the card laminated. I undertake to surrender the cghs cards on my leaving the ministry office on transfer. I undertake to surrender the cghs card s on ceasing to be eligible for cghs benefits.
Eligible serving employeespensioners have to apply online or in the prescribed form. A message will appear on the screen requesting to take a coloured printout and get the card laminated. Renewal of cghs plastic cards in delhi ncr regarding. Application form for renewal of cghs card serving employees. Certificate of necessity for bipap and bilevel ventilatory support. Application for renewal of plastic card pensioners mandate form for individuals. If i fail to intimate and if the cghs comes to know of the change then the cghs facility is. If in case cghs plastic card is lost or damaged the card holder has to immediately report to ad office, new delhi. Form b application for cghs card for pensioners of central. Click print cghs card a message will appear on the screen requesting to take a coloured printout and get the card laminated. Central govt pensioners and their eligible family members getting pension from central civil estimates 3. The following list of forms is available on cghs website.
Online transfer of cghs cards of serving employees on transfer from one cghs covered city to another cghs covered city reg. Suitable action including cancellation of cgh card shall. 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. A cghs beneficiary is required to apply for new cghs plastic cards three months in advance or within six months of expiry of validity of the plastic cards and it is recommended to keep a copy of the same as a proof of submission of application for renewal of card which can be produced on demand before the cghs authorities, if required, for availing the cghs benefits on the basis of old card. Form must be filled in triplicate along with the photographs and submit to administrationi.
Click print card for the beneficiary whose card needs to be printed. After downloading the card in pdf format beneficiary can take a colour print out and get it laminated for further. Download central government heath scheme cghs application for new plastic cghs cardfillable pdf which you can fill before print on your pclaptop. Click the below link to download the application form. Requisition for pensioners cghs cards 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. Plastic cards for cghs beneficiaries already enrolled and have not applied for plastic cards. It is responsibility of cghs card holder to keep the card safely in his custody. One can get a cghs card made from the office of ad jd of the city. Guidelines regarding printing and issue of cghs plastic card. No extra payment to be made, in case of life time cards. I had applied for renewal of my beneficiary id card no.
Application for renewal of plastic card pensioners. Click ok download or open the cghs card in pdf format. The claim papers are to be submitted to welfare officer, lok sabha secretariat, parliament house annexe near post office, new delhi, tel. How to check cghs card status online india study channel. Cghs procedure to get a membership plastic card cghs pres release with forms. Apply for new cghs plastic cards through online central. The plastic cards are available after one month of the application at the parent wellness centre of the card holder. Cghs application for new plastic card in fillable pdf. Online transfer of cghs cards from one city to another cghs. I undertake to surrender the cghs cards on ceasing to be eligible for cghs benefits. Cghs renewal of plastic card pensioners in fillable pdf.
Etender notice for empanelment of authorized local chemist for cghs ambala sep 2019. M no, mise 60242007 cghs hql cghs p dated 30111 december, 2009 wherein guidelines on issue of individual plastic cards to each cells beneficiary serving and rettred were isslled. It advices the various ministries on legal matters as well as is allotted with the attorney general of india etc whose services are shared by the ministries. I agree for the reimbursement as is admissible under the rules. The undersigned is directed to refer to this ministrys o. Medical formscertificate, cghs card form pensioners portal. Form for renewal of plastic cghs card for pensionersfillable pdf about forms compiled in pdf fillable as excel word format these forms retain the original format of the form. Apply online for central government health scheme plastic card. 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. Apply online for central government health scheme plastic. 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. 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.
Retired employees and dependent family members receiving pension from central civil estimates current members of parliament and exmembers lt. Department of legal affairs is a department under the ministry of law and justice, government of india, established in 1961. A provision is there to fill up data on application form available online. I undertake to intimate to cghs immediately if there is any change in dependency criteria of my family members included in this application form. Renewal of cghs plastic cards in delhi ncr cghs order. Feb 28, 2014 a application for renewal of cghs plastic cards in the prescribed proforma form aa alongwith requisite documents current photographs, copy of pay slip and address proof of residence, if changed, should be submitted through their administrative office to the office of additional director, cghs of the respective cghs city following the same procedure as prescribed for issue of fresh cghs card. Read this article to know complete details about plastic cards, application procedure and steps to check card status online. Cghs procedure to get a membership plastic card forms uploaded eligible serving employeespensioners have to apply in the prescribed form available on cghs website. Aarogya setu app now mandatory for all central govt employees. I satyavati sharma, had applied for renewal of my pensioners cghs beneficiary id card no. The form should be completely filled up with individual photographs pasted as specified in the form. Looking for information on the central government health scheme.
The introduction of this facility may kindly be given due publicity. Enter the one time passwordotp sent on registered mobile. Cghs beneficiaries without plastic card can also apply for the. Eligible serving employeespensioners have to apply in the prescribed form available on cghs website. Central government health scheme cghs list of cghs forms. Application for renewal of plastic card serving employees.
Along with the form, serving employees need to attach residence proof of self and dependents, age proof of children, and disability certificate of dependent aged above 25. A cghs beneficiary is required to apply for new cghs plastic cards three months in advance or within six months of expiry of validity of the plastic cards and it is recommended to keep a copy of the same as a proof of submission of application for renewal of card which can be produced on demand before the cghs authorities, if required, for. Dependency certificate in the prescribed form available in cghs website. I am a cghs beneficiary and the cghs card was valid at the time of treatment. Enter the one time password otp sent on registered mobile. Jan 24, 2018 nirman bhawan, new delhi dated the january, 2018. Issue of individual plastic cards to cghs beneficiaries regarding. Cghs procedure to get a membership plastic card forms uploaded eligible serving employeespensioners have to apply in the prescribed form available on cghs.
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