Get Form Mrc (s)

The FORM MRC (S) is a crucial document for employees seeking medical reimbursement under the Central Government Health Scheme. This guide provides clear, step-by-step instructions on how to accurately complete the form online.

Follow the steps to fill out the form successfully.

1. Press the ‘Get Form’ button to access the FORM MRC (S) and open it in your preferred online editor.
2. Enter the name of the principal cardholder in block letters. Ensure that you include all necessary details including the GHS beneficiary ID number.
3. Specify the entitlement type: Private, Semi-Private, or General.
4. Provide the permanent address of the principal cardholder along with a mobile telephone number and email address, if applicable.
5. Fill in the patient’s name and relationship with the principal cardholder.
6. List the name and address of the hospital or diagnostic center where treatment was received or tests conducted.
7. Indicate whether the hospital or diagnostic center is an employee or near GHS by answering 'Yes' or 'No.'
8. Detail the treatment for which reimbursement is being claimed by selecting either OPD treatment, indoor treatment, or tests and investigations.
9. State if the treatment was taken in an emergency by answering 'Yes' or 'No.'
10. Specify whether prior permission was obtained for the treatment by selecting 'Yes' or 'No.'
11. Indicate if you are subscribed to any health or medical insurance scheme, and if so, provide the relevant claim amount received.
12. Provide a detailed breakdown of medical expenses claimed, including total amounts for OPD treatment, indoor treatment, and tests/investigations.
13. Fill in your bank details, including the name of the bank, account number, branch, and IFSC code.
14. Complete the declaration by affirming that the statements made are true and accurate to the best of your knowledge.
15. Attach all required documents before submitting, including photocopies of the GHS card, discharge summary, and any other relevant documents.
16. Finally, save your changes, download the completed form, and print it for your records. You may also share it as needed.

Ready to get started? Fill out the FORM MRC (S) online today for your medical reimbursement!