Follow the steps to successfully complete the online application form.

1. Click ‘Get Form’ button to obtain the application form and open it for editing.
2. In Part 1, provide the patient details including their name, age, sex, MDID card number, mobile number, cooperative society name, main member's name, and your relation to the main member. Ensure all fields are accurately filled.
3. Move to Part 2, which must be filled by the treating doctor. Enter the doctor’s name, mobile number, presenting complaints with their duration, clinical findings, provisional diagnosis, qualification, email ID, and various medical details such as blood pressure, pulse, cardiovascular system, respiratory system, ICD code, proposed investigations, and treatment plans.
4. The doctor should state if there has been a road traffic accident and provide details regarding surgery, anesthesia used, and obstetric history as applicable.
5. In Part 3, the hospital must provide its name, address, estimated hospital expenses, probable admission date, accommodation details, duration of stay, city, phone number, fax number, and email if available. Fill in all expenses such as room rent, medicines, surgical expenses, professional charges, investigation charges, and total expenses accurately.
6. Review the patient and hospital declaration sections carefully. Make sure all necessary consents and declarations are signed by the patient, treating doctor, and include the hospital seal.
7. Once all sections are filled, you can save changes to your form, download it for printing or sharing, and ensure that all mandatory fields are completed.

Complete your Bhai Ghanhya Sehat Sewa Scheme application online for prompt assistance.