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APPLICATION FORM FOR UPGRADATION OF ECHS SMART CARD FOR EXISTING MEMBERS CARD HOLDERS FILL UP ALL DETAILS IN BOLD LETTERS Pensioner/Family Pensioner Name Relationship Self/Spouse/Father/ Mother/Son/Daughter of Service No Rank Name Existing Card Regn No Force Army/Navy/Air Force/Coast Guard/DSC/SFF As applicable Date of Demise of pensioner In case of family pensioner only Details of member/ dependents - Ser No Member/ Dependent Name with address and tele No with STD code if different from existing one Parent Polyclinic required Latest Colour Photo Passport Size with Red background UID No if available Total cards demanded Payment Details DD No Date Amount Rupees Bank Name a Physical Disability b War Disability Yes Please attach relevant documentary proof Signature of Applicant black ink Applicants to retain photocopy of this form duly receipted by polyclinic/Stn HQ/Regional Centre. PTO In case any changes required to the existing details please specify eg change of parent polyclinic chan....

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How to fill out the Echs Form Filling online

Filling out the Echs Form Filling online is a straightforward process that requires attention to detail. This guide will help you navigate each step effectively to ensure your application for upgradation of the ECHS smart card is filled out correctly.

Follow the steps to complete your ECHS form smoothly.

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin by filling in your full name as a pensioner or family pensioner in bold letters. Indicate your relationship to the service member, such as self, spouse, or dependent. Include the service number, rank, and name of the service member.
  3. Enter your existing card registration number accurately to ensure there are no discrepancies.
  4. Select your force affiliation from the options provided: Army, Navy, Air Force, Coast Guard, DSC, or SFF.
  5. If you are a family pensioner, specify the date of demise of the pensioner accordingly.
  6. List the details of each member or dependent, ensuring to provide their names, addresses, telephone numbers with STD codes (if different from the existing one), their relationship to you, and whether they require a parent polyclinic.
  7. Upload a recent passport-sized color photo of each member with a red background, and include any UID numbers if available in the designated spaces.
  8. Indicate the number of new cards demanded and provide the payment details. Include the DD number, date, and amount in Rupees.
  9. If applicable, indicate whether there is a physical or war disability and attach any relevant documentary proof.
  10. Sign the application using black ink and ensure to retain a photocopy of the completed form, duly receipted.
  11. If any changes to existing details are needed, specify each change, the reason for it, and include an additional sheet if necessary for more dependents.
  12. Once you have filled out all the necessary fields, review your application, save your changes, and proceed to download, print, or share the form.

Complete your ECHS form online today to access your upgraded smart cards with ease.

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(i) Discharge book copy. (ii) PPO copy. (iii) Death certificate of ESM (only in case of ESM demise). (iv) Disability Medical Certificate (In case of PWD).

Ex-Servicemen Contributory Health Scheme(ECHS) The Scheme aims to provide allopathic and AYUSH Medicare to Ex-servicemen pensioner and their dependents through a network of ECHS Polyclinics, Service medical facilities, Government hospitals, empanelled private hospitals/specified Govt.

If data needs correction and data printed on the card is same as verified online application. Login using login credentials go to block card. Block card selecting reason for “Change in Data”. After blocking go to change data tab and select edit option and write blank column provided under the field.

Filling the Application Form Online Select “ ONLINE SMART CARD APPLICATION” Select “ ONLINE APPLICATION” Click “OK” Click “ALREADY REGISTERED. ... Select the Application Category by clicking “Drag down Icon, small arrow” Fill in the EX SERVICEMAN (ESM) DETAILS. Upload Photo & Signature of Primary Beneficiary.

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© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232
Form Packages
Adoption
Bankruptcy
Contractors
Divorce
Home Sales
Employment
Identity Theft
Incorporation
Landlord Tenant
Living Trust
Name Change
Personal Planning
Small Business
Wills & Estates
Packages A-Z
Form Categories
Affidavits
Bankruptcy
Bill of Sale
Corporate - LLC
Divorce
Employment
Identity Theft
Internet Technology
Landlord Tenant
Living Wills
Name Change
Power of Attorney
Real Estate
Small Estates
Wills
All Forms
Forms A-Z
Form Library
Customer Service
Terms of Service
Privacy Notice
Legal Hub
Content Takedown Policy
Bug Bounty Program
About Us
Blog
Affiliates
Contact Us
Delete My Account
Site Map
Industries
Forms in Spanish
Localized Forms
State-specific Forms
Forms Kit
Legal Guides
Real Estate Handbook
All Guides
Prepared for You
Notarize
Incorporation services
Our Customers
For Consumers
For Small Business
For Attorneys
Our Sites
US Legal Forms
USLegal
FormsPass
pdfFiller
signNow
airSlate WorkFlow
DocHub
Instapage
Social Media
Call us now toll free:
+1 833 426 79 33
As seen in:
  • USA Today logo picture
  • CBC News logo picture
  • LA Times logo picture
  • The Washington Post logo picture
  • AP logo picture
  • Forbes logo picture
© Copyright 1997-2025
airSlate Legal Forms, Inc.
3720 Flowood Dr, Flowood, Mississippi 39232