Medical Forms

S. No. Title Download/Details
1 Application for CGHS Card for Employees
  1. Application CGHS Card for Employees (1).docx (29.87 KB)
2 Application for CGHS Card for pensioners
  1. Application CGHS Card for Pensioners_0.docx (34.89 KB)
3 Application Form for renewal of CGHS card (serving employees)- Form AA
  1. Renewal of CGHS Card for Employees.docx (15.69 KB)
4 Appendix-IV - Addition/Deletion to family
  1. Addition -Deletion to family.docx (15.97 KB)
5 Form for CGHS Contribution Payment Form (For Pensioners)
  1. CGHS Contribution Payment Form- Pensioner_0.docx (14.62 KB)
6 Form for Life Certificate For Renewal of CGHS Cards (For Pensioners)
  1. Life Certificate (1).docx (14.05 KB)
7 Form for reimbursement of medical claim (For Pensioner's)
  1. Reimbursement Form for Pensioners.docx (18.79 KB)
8 Form for reimbursement of medical claim (For Serving Employees)
  1. Reimbursement Form for Employees & AMAs.docx (18 KB)
9 Transfer of Dispensary - Appendix XV
  1. Transfer of Dispensary.docx (13.82 KB)