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Sgt. Suresh Yadav applied for membership in the Ex-Servicemen Contributory Health Scheme (ECHS). He submitted documents including his Pension Payment Order, category as general, service in the Indian Air Force from 702 SU, and current and permanent addresses in Allahabad, Uttar Pradesh. He paid Rs. 1062 for his card charges. This receipt is valid for 6 months from the date of issue for collecting his smart card once his application is processed.

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aman
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118 views

Index PDF

Sgt. Suresh Yadav applied for membership in the Ex-Servicemen Contributory Health Scheme (ECHS). He submitted documents including his Pension Payment Order, category as general, service in the Indian Air Force from 702 SU, and current and permanent addresses in Allahabad, Uttar Pradesh. He paid Rs. 1062 for his card charges. This receipt is valid for 6 months from the date of issue for collecting his smart card once his application is processed.

Uploaded by

aman
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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8/20/2021 https://echs.sourceinfosys.com/service/index_pdf.php?

content_id=5308&content_tid=526475838&content_type=temp

AUTO GENERATED
Registration No : 0000005308
RECEIPT FOR DOCUMENTS CUM TEMPORARY RECEIPT EX SERVICEMEN CONTRIBUTORY
HEALTH SCHEME (ECHS)
Received documents from No
790429TRank
SgtName
SURESH YADAV towards application for
1.
membership of Ex-Servicemen Contributory Health Scheme (ECHS) :-
Pension Payment Order No (PPO No)
(Attach
2. 349201613510
photocopy)
3. Category of Ward General
4. Force Type:
Air Force 5. Regiment/Unit:
AMBALA(702 SU,AF)
Permanent Address with State and Pin Code:
Current Address with State and Pin Code:

6. PLOT 171 MAYUR VIHAR COLONY JHALWA, PLOT 171 MAYUR VIHAR COLONY JHALWA,
KAUDIHAR, Allahabad, Uttar Pradesh , 211015 KAUDIHAR, Allahabad, Uttar Pradesh , 211015
7. Mobile No:
9416226359 8. DOB:
07 Apr 1978 9. Date of Retirement:
30 Nov 2016
10. Parent Polyclinic of Pensioner
Allahabad, MRO No.
(if applicable)
11. Card Charges @ Rs. 177/- paid Rs. :
1062 vide Transaction ID : CPR8877606
12. Valid Upto :
_________________
Father Mother

Name : RAM SAGAR YADAV Name : PARVATI DEVI


DOB : 20 May 1958 DOB : 01 Jan 1962
Aadhaar No. : 613330040011 Aadhaar No. : 552980496561
13. ACTIVATION BY
Signature _________________

Place: _____________

(Stamp with Rank, Name & Appointment, OIC


Date: _____________
Parent Polyclinic)
Notes :-
This original receipt is required to be returned at the time of collection of Smart Card (s).
Receipt will
1.
not be destroyed. This will be filed along with the original Application Form.
No Smart Card will be issued if this receipt in original is not produced and final verification by Central
2.
Org ECHS.
3. Record Office will retain this receipt after checking the Application Form till retirement of the individual
Stoppage of FMA and deposition of contribution (MRO) as applicable to be ensured prior to issue of this
4.
receipt to pre 01 Apr 2003 retirees by Regional Centre ECHS.
This receipt will be issued only on verification of original PPO and discharge book for old retirees who
5.
are not in possession of old Cards.
6. The Original Receipt is valid up to a maximum of SIX MONTHS from the date of issue.
7. Slip will be considered activated only after signatures of OIC Parent Polyclinic.
8. Aadhar verification to be ensured by Polyclinics.
9. Old cards/ temp receipts will be returned.
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8/20/2021 https://echs.sourceinfosys.com/service/index_pdf.php?content_id=5308&content_tid=526475838&content_type=temp

Date: 20 Aug 2021


Signature of ESM / Family Pensioner

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