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EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME (ECHS) APPLICATION FORM FOR MEMBERSHIP (REV 2015) (PLEASE FILL IN CAPITALS & IN BLUE INK) Place of Submission Category ( ) (a) Officer (b) JCO & Equivalent.

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How to fill out the ECHS Application Form for Membership Rev 2015 online

The ECHS Application Form for Membership Rev 2015 is a crucial document for ex-servicemen and their dependents seeking health coverage. This guide provides a detailed overview of how to effectively complete this application form online, ensuring a seamless process.

Follow the steps to successfully complete the application

  1. Click the ‘Get Form’ button to obtain the application form and open it in the online editor.
  2. Carefully fill in the Personal Details section. Include your service number, rank, and the full name of the ex-serviceman, adhering to the maximum character limits.
  3. In the Citizenship field, select the appropriate option (Indian or others). Ensure you mark the correct gender and marital status.
  4. Provide details about your monthly income and attach the applicant's recent passport-sized photograph in civil dress in the designated area.
  5. If applicable, ensure to fill out the Family Pensioner section with the necessary details regarding the family pensioner, including relationships and dependent statuses.
  6. Complete the sections pertaining to dependants, ensuring all required fields for each dependent such as name, gender, date of birth, and relationship to the ex-serviceman are filled correctly.
  7. Fill out any other additional information required in the various sections such as physical disability, drug allergies, and blood group.
  8. Review all the information you have entered to ensure accuracy, then proceed to save your changes.
  9. Once finished, you can download, print, or share the completed form as required, ensuring all attachments and necessary documentation are included.

Complete your ECHS membership application online today to access valuable healthcare benefits.

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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.

Documents Required For ECHS Card : Live Updates (i) Affidavit for Dependent (Appendix B) . (ii) Medical Certificate from Service Specialist (In case of PWD) (Appendix C). (iii) Birth Certificate / Matriculation certificate (In case of dependent brother / sister).

Step 1 : Click on the ECHS login link given below. Step 2 : If you have already registered, put the User ID (Mobile Number) and Password. If not registered, fill up the details and signed up. Step 3 : You will notice the present status of Card.

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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