
Get Dgehs Reimbursement Claim Form 2020-2025
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How to fill out the Dgehs reimbursement claim form online
This guide provides clear and detailed instructions on how to complete the Dgehs reimbursement claim form online. Whether you are a first-time user or familiar with the process, this comprehensive guide is designed to assist you in accurately submitting your medical claims.
Follow the steps to successfully complete the form online
- Click the ‘Get Form’ button to access the Dgehs reimbursement claim form and open it in your preferred editor.
- Begin by entering your DGEHS Card number and the place of issue in the appropriate fields.
- Indicate the validity period of your DGEHS Card by entering the start and end dates.
- Specify your ward entitlement by selecting from the options: Private, Semi Private, or General.
- Write the full name of the employee or beneficiary using block letters.
- Input your designation in the designated field.
- Review the checklist and tick (√) the relevant column for each document you are submitting, ensuring you attach all required documentation.
- Fill in the banking details, including the name of the bank, branch, SB account number, MICR code, IFS code, and contact number of the bank branch.
- Complete your contact information, including your telephone number and email address.
- Sign and date the form at the bottom to authenticate your claim.
- Once you have filled out the form completely, you can save your changes, download a copy, print it out, or share it as needed.
Start completing your Dgehs reimbursement claim form online today!
The Delhi Government Health Scheme (DGHS) offers financial support for medical expenses to eligible residents. This scheme provides various health services and allows individuals to submit reimbursement claims for eligible medical costs. Use the Dgehs Reimbursement Claim Form to ensure your claims are processed efficiently under this beneficial program.
Fill Dgehs Reimbursement Claim Form
Revised medical 2004 form for reimbursement of medical claims of DGEHS Beneficiaries. Photo copy of the CGHS card of the principal card holder along with the patient's CGHS Card. Copy of permission letter, if any. I am a CGHS beneficiary and the CGHC Card was valid at the time of treatment. I agree for the reimbursement as is admissible under the Rules. Date:. Subject: CGHS Medical Reimbursement Claim Form (for serving employees) Corner Type: CGHS Forms Attachment File: PDF icon Revised Med.Reimb_.Form-Serving.pdf
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