Copy of ID proof of dependent family members (Passport, PAN Card, Masked Aadhar, voter ID card etc.)

 Passport size photograph of all dependent family members.

 Pay slip of serving employee showing deduction of CGHS amount.

  Proof of Residential Address.

 PAN Not available declaration Click to Download PAN Not available Declartion Form

If dependent is son or minor brother

 All above and Proof of Age of Son/ Brother.

If dependent is Disabled Son or Disabled brother

 All above and Proof of Disability of Dependent Son or Brother.

 Copy of ID proof of dependent family members (Passport, PAN Card, Masked Aadhar, voter ID card etc.)

 Passport size photograph of all dependent family members.

 Self-attested PPO or Provisional PPO or Last pay certificate.

  Copy of Bharatkosh Challan for CGHS subscription paid.

  Proof of availing/non-availing FMA.

 Proof of Residential address.

 Duly filled and signed Nomination form/Nominee declaration. Click to Download Nominee Form

 PAN Not available declaration Click to Download PAN Not available Declartion Form