Get Lic Xray Format

Filling out the Lic Xray Format online is a straightforward process that ensures accurate reporting of chest x-ray results. This guide will provide you with a clear, step-by-step approach to completing each section of the form effectively.

Follow the steps to complete the Lic Xray Format online

1. Press the ‘Get Form’ button to access the Lic Xray Format and open it in your preferred editor.
2. In the 'Zone' field, select the appropriate zone related to the insurance proposal.
3. For 'Division,' indicate the relevant division associated with the insurance provider.
4. Enter the 'Proposal No.' in the specified field to reference the case accurately.
5. Fill in the 'Agent/D.O. Code' to identify the agent overseeing the proposal.
6. In the 'Introduced by' section, enter the name of the person who referred the proposal.
7. Complete the 'Full Name of Life to be assured' field with the individual’s complete name.
8. For 'Age/Sex,' provide the age and gender of the person being insured in the specified format.
9. Ensure to include the 'Branch' information along with the name and signature of the responsible individual.
10. Radiologists must follow the instructions provided, documenting the conditions of the lungs, heart, and aorta in detail.
11. Complete the declaration section, confirming the person being investigated has signed in your presence.
12. Finally, remember to save your changes, download, print, or share the form as required.

Start completing your documents online today!