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    Mediclaim Form

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    shamim22
    This document provides details for a mediclaim insurance policy for state government employees in the Commercial Taxes Department located in Jammu, J&K. It includes the name, designation, gender, relationship to employee, date of birth, address, contact information for Parvaiz Iqbal Khateeb and his dependents who are applying for coverage. Notes provide current location details for two of the dependents who are students living abroad for their education.

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Mediclaim Form

    Uploaded by

    shamim22
    41 views1 page
    This document provides details for a mediclaim insurance policy for state government employees in the Commercial Taxes Department located in Jammu, J&K. It includes the name, designation, gender, relationship to employee, date of birth, address, contact information for Parvaiz Iqbal Khateeb and his dependents who are applying for coverage. Notes provide current location details for two of the dependents who are students living abroad for their education.

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    This document provides details for a mediclaim insurance policy for state government employees in the Commercial Taxes Department located in Jammu, J&K. It includes the name, designation, gender, relationship to employee, date of birth, address, contact information for Parvaiz Iqbal Khateeb and his dependents who are applying for coverage. Notes provide current location details for two of the dependents who are students living abroad for their education.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    41 views1 page

    Mediclaim Form

    Uploaded by

    shamim22
    This document provides details for a mediclaim insurance policy for state government employees in the Commercial Taxes Department located in Jammu, J&K. It includes the name, designation, gender, relationship to employee, date of birth, address, contact information for Parvaiz Iqbal Khateeb and his dependents who are applying for coverage. Notes provide current location details for two of the dependents who are students living abroad for their education.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 1

    Mediclaim Insurance Policy for all the State Government (Gazetted) Employees.

    1. Department:- COMMERCIAL TAXES


    2. Complete Location/ Address of the Department/ Office:- EXCISE AND TAXATION BUILDING, RIAL HEAD COMPLEX, PANAMA CHOWK
    3. District:- JAMMU
    4. Name of the Concern DDO:- PARVAIZ IQBAL KHATEEB (KAS)
    5. Mobile No:- 9419129037
    S.No
    Name of the Employee
    and his/her dependents
    Designation of
    the employee
    Ge
    nd
    er
    M
    /F
    Relation
    with
    Employee
    Date of
    Birth
    D/M/Y
    Residential
    Address of the
    Employee
    District
    Pin
    Code
    Employees
    Contact No
    e. mail ID if any
    1
    PARVAIZ IQBAL KHATEEB ADDITIONAL
    COMMISSIONER
    (ADM)
    JAMMU
    M SELF 02/02/1958 194- ALLAMA
    IQBAL LANE
    NOW-ABAD
    JAMMU
    JAMMU 180011 9419129037 pikhateeb@
    yahoo.com
    2
    SYED TASNEEMA BANOO F WIFE 18/03/1960 -DO- -DO- -DO- 9419122695 -DO-
    3
    BASHIR AHMED KHATEEB M FATHER 24/01/1935 -DO- -DO- -DO- 9419155194 -DO-
    4
    ARSHA BEGUM F MOTHER 06/03/1940 -DO- -DO- -DO- 8716011005 -DO-
    5
    ERUM WARIS F DAUGHTER 31/03/1990 -DO-(note 1) -DO- -DO- 9419785731 -DO-
    6
    BURHAN UD DIN M SON 29/07/1992 -DO-(note 2) -DO- -DO- 09712295637 [email protected]

    Note:- 1.AT PRESENT STUDYING IN SIR SALIMULLAH MEDICAL COLLEGE DHAKA AND STAYING IN ROOM 310, LADIES HOSTEL SIR SALIMULAH MEDICAL COLLEGE
    MITFORT, OLD DHAKA, BANGLADESH.
    2. AT PRESENT STUDYING IN NATIONAL INSTITUTE OF DESIGN AHMEDABAD AND STAYING IN ROOM 314, HOSTAL B NATIONAL INSTITUTE OF DESIGN, PALDI,
    GUJRAT, INDIA. PIN 380007

    Seal & Signature of the DDO/HOD
    With Name___________________

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