Version 1.0
2
INDEX
CONTENTS
PAGE NO.
PART – I : INTRODUCTION
4-10
PART – II : INSTRUCTIONS FOR APPLICANTS
11
Chapter-1: FUTURE RETIREE
12-14
Chapter-2:TEMPORARY SLIP HOLDER
15-17
Chapter-3:OLD SMART CARD HOLDER
18-20
Chapter-4:PENSIONERS BETWEEN 01 APR 1996 TO 31 MAR 2003
21-24
Chapter-5:PRE 1
ST
APR 1996 PENSIONERS
25-28
Chapter-6:INSTRUCTIONS FOR COLLECTION & ACTIVATION OF SMART CARD
29-30
PART – III : INSTRUCTIONS FOR FUNCTIONARIES
31
Chapter-1: CENTRAL ORGANISATION ECHS
32-33
Chapter-2: RECORD OFFICE
34-35
Chapter-3: REGIONAL CENTRE
36-38
Chapter-4: STATION HEADQUARTER
39-41
Chapter-5: POLYCLINIC
42
PART – IV : APPENDICES
43
Appendix – A : Military Receivable Order (MRO)
44
Appendix – B : Affidavit for Dependents
45-46
Appendix – C : Disability Certificate
47
Appendix – D : Self Declaration Certificate for Children Above 18 Years
48
Appendix – E : DPDO/BANKER’s Certificate
49
3
PART – I
4
INTRODUCTION
Background
1. ECHS was established in the year 2003. An agreement with Smart Card Making agency
(SITL) was signed on 27 January 2004 for a period of five years i.e. upto 2009 which was extended
for one year upto 2010. Thereafter, the same company i.e. SITL was again contracted for a period of
five years from May 2010 to May 2015. After the expiry of the contract, the competent authority
approved issue of fresh open tenders.
2. Accordingly, RFP for new ECHS Smart Card was floated in Jul 2016. The ECHS Smart Card
project was approved by Hon’ble RM on 17 Jul 2017 and subsequently, the contract was awarded to
the Smart Card Making Agency, Source DOT Com Pvt Ltd on 19 Jul 2017. The application will be
filled online and mode of payment for Smart Card charges will also be through online payment.
Activation of Smart Card will also be possible online / through registered mobile number.
New Smart Card
3. The new Smart Cards are Dual interface (contact and contactless) with Fingerprint Biometrics
authentication through Aadhaar based system. The new Smart Card will enforce authorised usage
as per laid down policies of the ECHS scheme so that misuse and inappropriate usage is prevented.
Policies governing the authorization of the ECHS benefits to the members will be enforced through
application deployed for the Smart Card.
4. Salient Features of New Smart Card. The salient features of new ECHS Smart Card are
appended below:-
(a) The physical submission of application for ECHS Smart Card has been done away
with.
(b) ECHS beneficiaries can now apply online for Smart Card without visiting Regional
Centres.
(c) The payment for Smart Card will also be done through online mode with options using
Net Banking, Debit / Credit Card, Wallet Payments.
(d) The information regarding movement of online application till receipt of Smart Card
from Station Headquarters will be intimated to beneficiaries through SMS updates.
(e) The new Smart Card is of the capacity of 64 Kb which can store vital information of the
beneficiaries including their Medical History, Referral History, Medicine Issue Logs etc.
(f) In the new system, Kiosks are being deployed at ECHS Polyclinics which offers
Biometric/Aadhaar/mobile based Authentication of beneficiaries, Selection of option for
desired services through touch screen, Printing of Medical Slip/authentication slip and also
helps in Queue Management.
(g) In the new system, Identification cum Authentication Terminals (ICAT) are being
deployed at HCOs which also offers Biometric/Aadhaar/mobile based Authentication of
beneficiaries.
5. Priority for issue of new ECHS Smart Cards. The following order of priority will be followed
for issue of new ECHS Smart Cards.
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(a) Future Retiree.
(b) Temporary Slip Holders.
(c) 16 Kb Card Holders.
(d) 32 Kb Card Holders.
(e) Any Other Category.
6. Mentioning of Aadhaar Card number, PAN number, mobile number and e-mail address is
mandatory. Mention mobile number accessible to you to receive SMS updates regarding Smart
Card. This mobile number will also be utilised for generating SMS alerts for updating on the claim
status. This mobile number should be used for all ECHS related transactions.
7. Procedure for changing of Registered Mobile number. The Procedure for changing of
Registered Mobile number in respect of Primary Beneficiary / ESM and Dependents is described
below:-
(a) Primary Beneficiary / ESM
(i) Visit parent polyclinic with new activated mobile number.
(ii) Obtain token for change of mobile number from Kiosk.
(iii) Visit OIC Polyclinic with token.
(iv) OIC Polyclinic will change the mobile number on online portal after due
verification of Smart Card.
(b) Dependents
(i) Login to ECHS Smart Card website by visiting http://www.echs.gov.in.
(ii) Select the option change dependent mobile number from the menu.
(iii) Click on dependent for whom mobile number is required to be changed.
(iv) Enter new mobile number, re-enter new mobile number of dependent.
(v) Click on Get OTP, an OTP will be forwarded on Primary Beneficiaries mobile
number.
(vi) Enter OTP received and click on submit.
(vii) A confirmation message will appear on screen along with a confirmation SMS on
mobile number of Primary Beneficiary / ESM.
8. ECHS Contribution
(a) Ex-Servicemen Retired Prior to 01 Apr 03.
(i) Should deposit one time ECHS contribution in Govt Treasury/Nationalized bank
through Military Receivable Order (MRO) (Appendix – A) as per rates of subscription.
(ii) Scanned copy of receipt of MRO is to be attached.
(b) Ex –Servicemen Retired/Retiring After 01 Apr 03. Subscription is being deducted
directly by CDA (P) and reflected in PPO.
(c) Rates of Contribution w.e.f 01 Jun 2009(as per 6
th
CPC) are as under (Subject to
Revision) :-
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Rate of Contribution
Rs 15,000/-
Rs 27,000/-
Rs 39,000/-
Rs 60,000/-
(d) Rates of contribution are subject to revision as per 7
th
CPC.
9. Category of Ward
Officers - Private ward
JCO & Equivalent - Semi Private ward
ORs & Equivalent - General ward
Notes:(i) War Disabled Pensioners/War Widows/NOK of Battle Casualties are exempted
from paying ECHS subscription.
(ii) Fixed medical Allowance will be stopped from date of ECHS membership.
(iii) All pensioners who have retired prior to 01 Jan 1996 are exempted from paying
ECHS contribution.
(iv) Nb Sub to Sub Maj including Hony Ranks of Lt/Capt and Equivalent are
authorized for Semi Private ward.
(v) Sep to Hav including Hony Ranks of Nb Subedar and Equivalent are authorized
General ward.
10. Eligibility – Ex-servicemen
(a) Should be an Ex-Serviceman and drawing pension/disability pension/family pension
from Controller of Defence Accounts including Indian Coast Guard personnel.
(b) War Widows (Veer Naris) / NOK of Battle causalities.
(c) Personnel disabled in Operations.
(d) Recruits medically boarded out during training and in receipt of disability pension.
Notes:(i) Ex-Servicemen not drawing pension are NOT eligible.
(ii) To take benefits of ECHS you CAN NOT be drawing benefits of any other
Government Medical Scheme.
(iii) Monetary allowance for gallantry awards without pension is not an authority for
membership.
(iv) Pre-1986 retirees need not deposit copy of PPO. Copy of Discharge Book /
pension Book giving name of spouse and bankers certificate to be submitted with
application.
(v) Deduction of contribution by the CDA is no guarantee for grant of membership.
11. Eligibility – Dependents
(a) Spouse.
(b) Unemployed Son(s) up to 25 years of age (with self declaration certificate and affidavit).
(c) Minor brother(s) upto the age of becoming a major (18 years).
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(d) Unemployed/unmarried Daughter (s) / Sister including widow / legally divorced
irrespective of age (with self declaration certificate and affidavit).
(e) Physically / Mentally handicapped child / brother / sister for life (with valid disability
certificate) as per PWD Act 1995.
(f) Wholly dependent Parents whose combined monthly income from all sources does
not exceed Rs.9000/- plus DA per month from all sources and are generally residing with
the member.
(g) Parents of deceased soldier can be eligible, subject to meeting dependency criteria.
(h) If both husband and wife are Defence Personnel, parents of both members are eligible
if both pay subscription, subject to meeting dependency criteria.
(j) Financial limit criteria will be applicable to all dependents except spouse.
Notes :(i) Widow after remarriage in receipt of family pension is eligible for ECHS
membership along with her children from first marriage. However, her present
Husband and children born later are not entitled.
(ii) Grand Parents are not entitled.
(iii) Children of widowed/separated daughters of primary beneficiary upto the age
of becoming a major (upto 18 years of age) are entitled.
(iv) Part-II Orders endorsement by service Headquarters/respective Records for
marriage/children born after retirement along with birth certificate is essential.
(v) The following additional documents will be attached with the application form for
the following dependents:-
(aa) Abandoned/Divorced/Widowed Daughter/Sister
(aaa) Court order of divorce decree along with an affidavit of current
address with employment and income status.
(aab) Death Certificate of late husband along with birth certificate of
dependent children (i.e grandchildren of primary beneficiary).
(aac) Financial documents for past three years to incl IT returns, PAN
Card and bank statement of past one year duly certified by the concerned
bank.
(aad) Affidavit for abandonment by spouse alongwith present address
and employment status.
(aae) Self declaration certificate by the beneficiary with Aadhaar and
PAN details.
(ab) Disabled Child. Medical certificate from a Service Hospital duly signed
by the concerned specialist regarding the eligibility of the disability. Disability will
be decided as per ‘Persons with Disability (PWD) Act’ 1995 or as amended later.
The disabilities as per Act are as follows:
(aaa) Blindness; (aab) Low vision; (aac) Leprosy-cured; (aad) Hearing
impairment; (aae) Loco motor disability; (aaf) Mental retardation;
(aag) Mental illness;
In addition, following requirements are also to be fulfilled for availing
ECHS facilities:
(aaa) The disability percentage is required to be minimum 40%.
(aab) Not able to earn livelihood.
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(aac) Approval of eligibility of White Card will be done by Central
Organisation ECHS.
(j) PAN card details are mandatory for all dependents above 18 Years.
(k) Self declaration certificate for all dependent children above 18 years to be
submitted every year to parent polyclinics (except White Card holders).
12. Penal Actions. The new system allows monitoring of usage of ECHS facilities by ECHS
beneficiary over the online environment. Any mis-utilization of ECHS card or ECHS facilities other
than authorised person, reported by any agency will invite to punitive actions. Any fraudulent cases
detected or reported will invite permanent cancellation of ECHS membership and recovery
action for medical expenditure incurred on such unauthorised beneficiary.
13. Photo Requirements / Size. The quality of the photograph appearing on the Smart Card
depends on the photograph that is uploaded at the time of applying for a Smart Card. The applicants
are, therefore, advised to upload the photographs, as specified, to avoid delay in processing their
Smart Card applications.
(a) Photo Specifications.
(i) Size: 51mm x 51mm or 2x2 inches.
(ii) Color: Natural color so skin tone is clearly visible.
(iii) Head size and position: Head needs to be centered and looking at the camera.
(iv) Head should be 35mm to 40mm.
(v) Regency: Taken in the last 6 months.
(vi) Background: Plain white and solid design.
(vii) Smile: No smile. Only neutral expression.
(viii) Eyes: Open and looking directly at camera.
(ix) Glasses: Only prescription glasses are permitted.
(x) Headgear: Religious purposes only and cannot block face.
(xi) Attire, clothing, dress code: Casual or professional preferred.
(xii) Beard: Optional.
(b) ECHS Smart Card Photo Requirements, Rules, Guidelines, and specifications. A
detailed and more in depth breakdown of what you can look for and expect when readying
these Smart Card photos are as follows:
(i) Black or White, filtered or old photos are not permitted. Be sure the photos
uploaded are of high quality and not crinkled, torn or creased. Do not adjust color
saturation. Keep it clear from dust or scratches. -Any background of color or designs
such as scenery or shapes are not accepted.
(ii) Leave the sunglasses or tinted prescription lenses out of the picture. Your eyes
need to be visible.
(iii) If you have glasses with thick frames obstructing the view of your eyes, remove
them for the photo. Also, be conscious of glare as any reflection will be rejected.
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(iv) No hats or other headwear unless for religious purposes are not allowed.
Shadows caused by hair, glasses or flash photography will cause a rejection of the
photo.
(v) Avoid red eye. Only you can be in the photo. No other objects or people.
(vi) Keep hair pulled back or off the face. Nothing should obscure your face from the
camera.
(vii) Clarity, decent lighting and focus is key. Any photo which is blurred, stretched,
overexposed or underexposed will be rejected.
(c) Rules and requirements for photos of babies, infants, and newborns for Smart
Card. Children and especially infants can be a bit tricky to photograph. With this knowledge,
several exceptions and relaxed standards have been allowed. Keep in mind details regarding
the quality of the photo still apply as listed above. Every child in your family who is receiving a
Smart Card must have their own photo completed. Here is advice for taking photos of children,
infants and remaining compliant:
(i) Infants under the age of 12 months old do not need to have their eyes open. If
you can get a shot with open eyes, that’s acceptable too.
(ii) Infants do not need to be completely centered with the photo.
(iii) If holding or sitting an infant, no object or hands may be visible. Use a white
sheet to block these objects if needed. No toys or pacifiers.
(iv) Children under the age of 10 and older than 1 year need to have eyes open.
(v) Try to square the child’s head and shoulders with the photo.
(vi) The photographs of the minor children (below 18 years) will need to be
updated on the online system every five years. The individual just needs to login
to their account and update the photographs of their child in the online system.
14. Signature/Thumb Impression. The quality of the signature / thumb impression appearing on
the Smart Card depends on the image that is uploaded at the time of applying for a Smart Card. The
applicants are, therefore, advised to upload the signature/thumb impression, as specified, to avoid
delay in processing their Smart Card applications.
(a) Signature / Thumb Impression Specifications.
(i) The applicant/dependents have to sign/put thumb impression on plane white
paper with Blue Ink.
(ii) The signature/thumb impression must be of the applicant/dependent and not by
any other person.
15. Guidelines for Scanning the Photograph & Signature. Before applying online an applicant
will be required to have a scanned (digital) image of his/her and dependents photograph and
signature as per the specifications given below. Your online application will not be registered unless
you upload all photographs and signatures as specified.
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16. Scanning the Photograph & Signature / Thumb Impression:
(a) Either scan or take a picture of photograph / signature / thumb impression for uploading
on to the online application.
(b) Crop the image to the edge of the photograph/signature/thumb impression.
(c) There is no specified file size for uploading. Files of any size can be uploaded.
(d) Image of any format can be uploaded.
17. Procedure for Uploading the Photograph and Signature/Thumb Impression.
(a) There will be two separate links for uploading Photograph and Signature.
(b) Click on the respective link "Photograph / Signature"
(c) Browse & Select the location where the Scanned Photo / Signature file has been
saved.
(d) Select the file by clicking on it.
(e) Click the 'Upload' button.
Note:
1. In case the face in the photograph or signature is unclear, the applicant’s application may be
rejected.
2. In case any of the photograph or signature is unclear, the applicant may edit the application
and re-upload the photographs or signature before proceeding for payment.
3. If the photographs / signatures on the Smart Card, at the time of presenting for treatment at
ECHS Polyclinic, does not match, the ECHS membership may be cancelled.
11
PART - II
12
CHAPTER – 1
GUIDELINES & INSTRUCTIONS FOR FILLING UP OF
ECHS SMART CARD ONLINE APPLICATION FORM – FUTURE RETIREE
1. FUTURE RETIREE. Service personal who are due for retirement / discharge in the next six to
eight months or proceeding premature retirement will be covered under this category. They are
required to fill the online Smart Card Application under Future Retiree category available on the
online portal.
(a) Registration Process.
(i) Visit ECHS website http://www.echs.gov.in then click on the tab Online Smart
Card Application – Online Application.
(ii) Enter your name, service number along with valid mobile number and e-mail ID
(for receiving One Time Password) and new password then click on tab Register.
(iii) Verify your e-mail ID with the OTP received on your mail.
(iv) Verify your mobile number with the OTP received on your mobile.
(v) Registration process is complete after successful mobile OTP verification.
(vi) After successful registration, a message will be displayed that Registration
Process successful, proceed for Eligibility Check Process. One can login any time
using registered e-mail ID and password to fill the online ECHS smart card application
by clicking Already Registered Click to Login.
(vii) The Registration details will be valid only for a period of 15 days, if the
application is not filled completely and payment is not done for Smart Card. After 15
days period previous registration will expire and a new registration process has to be
followed.
(b) Eligibility Check Process.
(i) Click on the tab ‘Future retiree’.
(ii) Select your Disability details (if any).
(iii) Select your citizenship, state then enter your Aadhaar number and Date of Birth.
(iv) To add dependents, click on the ‘Add Dependent’ button.
(v) Enter the Dependent Name, Dependent Relation, Dependent Date of Birth,
Dependent Marital Status, Dependent Monthly Income, Dependent Mobile Number,
Dependent Email ID, Dependent Disability Details (if any), Dependent Postal Address,
if same as primary beneficiary then select Address same as Primary Beneficiaries
Current Address else enter address of dependent, enter Dependent Aadhaar Number.
(vi) For white card eligibility, select physical disability as per The Person With
Disabilities, PWD Act 1995 from the drop down menu. Attaching of scanned copy of
medical certificate by service specialist as per format provided is a mandatory
13
requirement. Please note if the certificate has been issued based on ailment same is
NOT valid irrespective who has signed.
(vii) In case no other dependents need to be added click on ‘If No Dependents then
Proceed to Verification’ button, else click on the ‘Add Dependent’ button to add more
dependents and follow steps (iv) and (v).
(viii) In case of any discrepancies in the eligibility criteria of any dependent, a
message will be displayed and respective field will be highlighted. Check and correct
the same for proceeding further to verification process.
(ix) On successful verification, a message will be displayed that Eligibility Check
completed successfully, proceed for Detailed Application.
(c) Detailed Application
(i) Click on the photo tab and upload your recent passport size photograph in civil
dress.
(ii) Select your Gender, Date of Commission / Enrolment, Date of Retirement/
Release, Type of Pension, Type of Service, Category, Rank, Last unit served,
Record Office, PPO Number (if known).
(iii) Click on signature tab and upload a photo of your signature.
(iv) If disability was selected, then enter your disability percentage. It should be 40%
or more.
(v) Enter details as required in the preceding columns.
(vi) Select Regional Centre, then select Polyclinic from the available options as
per your address of residence and Station HQ will be auto populated.
(vii) Enter your permanent address, select district, tehsil and pin code.
(viii) Check in the tab to enter your Current Address if different from Permanent
Address.
(d) For Dependents.
(i) Upload recent passport size photograph and photo of signature/thumb
impression of the dependent by clicking on the tabs.
(ii) Enter details in respect of dependent as required in the preceding columns.
(iii) Follow same procedure for addition of all the dependents.
(iv) Details in the application can be edited any time before submission.
(v) Dependent if added erroneously can be deleted before submission of form.
(e) Attachments.
(i) Affidavit for Dependent (Appendix B) .
14
(ii) Medical Certificate from Service Specialist (In case of PWD) (Appendix C).
(iii) Birth Certificate / Matriculation certificate (In case of dependent brother / sister).
(iv) Self attestation proforma (In case of children above 18 years of age excluding
children with White Cards) (Appendix D).
(v) On successful filling of Detailed Application, a message will be displayed that
Detailed Application filled up successfully proceed for Payment.
(f) Payment.
(i) You will be directed to a new window for payment for ECHS Smart Cards.
Please note that the cost of one Smart Card is Rs. 177/- (inclusive of all taxes)
plus transaction charges extra (as applicable). Separate card will be needed for
all members.
(ii) Select mode of payment and proceed as directed.
(iii) On successful payment a confirmation SMS is forwarded to the registered
mobile number of primary beneficiary along with an Application number.
(iv) A message is displayed Payment successful, Proceed for Temporary Slip
Generation.
(g) Temporary Slip.
(i) Online generated Temporary slip is required to be taken to nearest polyclinic for
activation along with all related service documents for ECHS membership. Temporary
Slip will be signed by OIC Polyclinic only after physical verification of the documents (in
original).
(ii) Temporary slip can be used in the interim period for availing ECHS facilities till
the issue of ECHS Smart Card.
(iii) On receipt of Smart Cards at Station HQ an intimation SMS will be forwarded to
your registered mobile number. The Smart Cards are required to be collected by every
dependent in person from Station HQ with deposit of Temporary slip.
(h) Observations by Record Office.
(i) In case of any observation raised by your Record Office, the application will be
reverted back to you for correction. You will get an intimation SMS regarding
observations by Record Office.
(ii) Observations raised by the Record Office will be spelt out in your login.
(iii) Correct the observations and re-submit the application to Record Office for
further processing of Smart Card application.
15
CHAPTER – 2
GUIDELINES & INSTRUCTIONS FOR FILLING UP OF
ECHS SMART CARD ONLINE APPLICATION FORM – TEMPORARY SLIP HOLDERS
1. TEMPORARY SLIP HOLDERS. The ex-servicemen / family pensioners who are in the
possession of Temporary Slip will be covered under this category. They are required to fill the online
Smart Card Application under Temporary Slip Holders category available on the online portal.
(a) Registration Process.
(i) Visit ECHS website http://www.echs.gov.in then click on the tab Online Smart
Card Application – Online Application.
(ii) Enter your name, service number along with valid mobile number and e-mail ID
(for receiving One Time Password) and new password then click on tab Register.
(iii) Verify your e-mail ID with the OTP received on your mail.
(iv) Verify your mobile number with the OTP received on your mobile.
(v) Registration process is complete after successful mobile OTP verification.
(vi) After successful registration, a message will be displayed that Registration
Process successful, proceed for Eligibility Check Process. One can login any time
using registered e-mail ID and password to fill the online ECHS smart card application
by clicking Already Registered Click to Login.
(vii) The Registration details will be valid only for a period of 15 days, if the
application is not filled completely and payment is not done for Smart Card. After 15
days period previous registration will expire and a new registration process has to be
followed.
(b) Eligibility Check Process.
(i) Click on the tab ‘Temporary Slip Holders’
(ii) Select your Disability details (if any).
(iii) Select your citizenship, state then enter your Aadhaar number and Date of Birth.
(iv) To add dependents, click on the ‘Add Dependent’ button.
(v) Enter the Dependent Name, Dependent Relation, Dependent Date of Birth,
Dependent Marital Status, Dependent Monthly Income, Dependent Mobile Number,
Dependent Email ID, Dependent Disability Details (if any), Dependent Postal Address,
if same as primary beneficiary then select Address same as Primary Beneficiaries
Current Address else enter address of dependent, enter Dependent Aadhaar Number.
(vi) For white card eligibility, select physical disability as per The Person With
Disabilities, PWD Act 1995 from the drop down menu. Attaching of scanned copy of
medical certificate by service specialist as per format provided is a mandatory
16
requirement. Please note if the certificate has been issued based on ailment same is
NOT valid irrespective who has signed.
(vii) In case no other dependents need to be added click on ‘If No Dependents then
Proceed to Verification’ button, else click on the ‘Add Dependent’ button to add more
dependents and follow steps (iv) and (v).
(viii) In case of any discrepancies in the eligibility criteria of any dependent, a
message will be displayed and respective field will be highlighted. Check and correct
the same for proceeding further to verification process.
(ix) On successful verification, a message will be displayed that Eligibility Check
completed successfully, proceed for Detailed Application.
(c) Detailed Application.
(i) Click on the photo tab and upload your recent passport size photograph in civil
dress.
(ii) Select Gender, Date of Commission / Enrolment, Date of
Retirement/Release, Type of Pension, Type of Service, Category, Rank, Last unit
served, Record Office, PPO Number.
(iii) Click on signature tab and upload a photo of your signature.
(iv) If disability was selected, then enter your disability percentage. It should be 40%
or more.
(v) Click on the Family Pensioner photo tab and upload your recent passport size
photograph (in case of ESM Demise).
(vi) Click on Family Pensioner signature tab and upload a scanned copy of your
signature (in case of ESM Demise).
(vii) Enter the Family Pensioner Details in the preceding columns (in case of ESM
Demise).
(viii) Enter details as required in the preceding columns.
(ix) Select Regional Centre, then select Polyclinic from the available options as
per your address of residence and Station HQ will be auto populated.
(x) Enter your permanent address, select district, tehsil and pin code.
(xi) Check in the tab to enter your Current Address if different from Permanent
Address.
(xii) Entering Temporary Slip number of primary member and attaching a copy of
the same is mandatory requirement.
(d) For Dependents.
(i) Upload recent passport size photograph and photo of signature/thumb
impression of the dependent by clicking on the tabs.
17
(ii) Enter details in respect of dependent as required in the preceding columns.
(iii) Follow same procedure for addition of all the dependents.
(iv) Details in the application can be edited any time before submission.
(v) Dependent if added erroneously can be deleted before submission of form.
(e) Attachments.
(i) Discharge book copy.
(ii) PPO copy.
(iii) Death certificate of ESM (only in case of ESM demise).
(iv) Disability Medical Certificate (In case of PWD).
(v) Old Temporary Slip copy.
(vi) Affidavit for Dependent.
(vii) Birth Certificate / Matriculation certificate (In case of dependent brother / sister).
(viii) Self attestation proforma (In case of children above 18 years of age excluding
children with White Cards).
(ix) On successful filling of Detailed Application, a message will be displayed that
Detailed Application filled up successfully proceed for Payment.
(f) Payment.
(i) You will be directed to a new window for payment for ECHS Smart Cards.
Please note that the cost of one Smart Card is Rs. 177/- (inclusive of all taxes)
plus transaction charges extra (as applicable). Separate card will be needed for
all members.
(ii) Select mode of payment and proceed as directed.
(iii) On successful payment, a confirmation SMS is forwarded to the registered
mobile number of primary beneficiary along with an Application number.
(g) Observation by Record Office.
(i) In case of any observation raised by your Record Office, the application will be
reverted back to you for correction. You will get an intimation SMS regarding
observations by Record Office.
(ii) Observations raised by the Record Office will be spelt out in your login.
(iii) Correct the observations and re-submit the application to Record Office for
further processing of Smart Card application.
18
CHAPTER – 3
GUIDELINES & INSTRUCTIONS FOR FILLING UP OF
ECHS SMART CARD ONLINE APPLICATION FORM – 16KB/32KB CARD HOLDERS
1. 16KB/32KB CARD HOLDERS. The ex-servicemen / family pensioners who are in the
possession of Old Smart Card will be covered under this category. They are required to fill the online
Smart Card Application under Existing Card Holders category available on the online portal and
thereafter select relevant category i.e. 16 KB Card Holder or 32 KB Card Holder. 16KB Cards will
stop working in the new system with effect from 01 Sep 2018. Applying for new 64 KB cards
for 32 KB Cards holders is optional till the year 2020. However, they can also apply to get the
benefits of new Smart Card.
(a) Registration Process.
(i) Visit ECHS website http://www.echs.gov.in then click on the tab Online Smart
Card Application – Online Application.
(ii) Enter your name, service number along with valid mobile number and e-mail ID
(for receiving One Time Password) and new password then click on tab Register.
(iii) Verify your e-mail ID with the OTP received on your mail.
(iv) Verify your mobile number with the OTP received on your mobile.
(v) Registration process is complete after successful mobile OTP verification.
(vi) After successful registration, a message will be displayed that Registration
Process successful proceed for Eligibility Check Process. One can login any time
using registered e-mail ID and password to fill the online ECHS smart card application
by clicking Already Registered Click to Login.
(vii) The Registration details will be valid only for a period of 15 days, if the
application is not filled completely and payment is not done for Smart Card. After 15
days period, previous registration will expire and a new registration process has to be
followed.
(b) Eligibility Check Process.
(i) Click on the tab ‘Old Smart Card Holders’.
(ii) Click on the tab ‘16KB Card Holder’ or ‘32KB Card Holder’ as applicable.
(iii) Select your Disability details (if any).
(iv) Select your citizenship, state then enter your Aadhaar number and Date of Birth.
(v) To add dependents, click on the ‘Add Dependent’ button.
(vi) Enter the Dependent Name, Dependent Relation, Dependent Date of Birth,
Dependent Marital Status, Dependent Monthly Income, Dependent Mobile Number,
Dependent Email ID, Dependent Disability Details (if any), Dependent Postal Address,
19
if same as primary beneficiary then select Address same as Primary Beneficiaries
Current Address else enter address of dependent, enter Dependent Aadhaar Number.
(vii) For white card eligibility, select physical disability as per The Person With
Disabilities, PWD Act 1995 from the drop down menu. Attaching of scanned copy of
medical certificate by service specialist as per format provided is a mandatory
requirement. Please note if the certificate has been issued based on ailment same is
NOT valid irrespective who has signed.
(viii) In case no other dependents need to be added, click on ‘If No Dependents
then Proceed to Verification’ button, else click on the ‘Add Dependent’ button to add
more dependents and follow steps (v) and (vi).
(ix) In case of any discrepancies in the eligibility criteria of any dependent, a
message will be displayed and respective field will be highlighted. Check and correct
the same for proceeding further to verification process.
(ix) On successful verification, a message will be displayed that Eligibility Check
completed successfully, proceed for Detailed Application.
(c) Detailed Application.
(i) Click on the photo tab and upload your recent passport size photograph in civil
dress.
(ii) Select Gender, Date of Commission / Enrolment, Date of
Retirement/Release, Type of Pension, Type of Service, Category, Rank, Last unit
served, Record Office, PPO Number.
(iii) Click on signature tab and upload a photo of your signature.
(iv) If disability was selected, then enter your disability percentage. It should be 40%
or more.
(v) Click on the Family Pensioner photo tab and upload your recent passport size
photograph (in case of ESM Demise).
(vi) Click on Family Pensioner signature tab and upload a scanned copy of your
signature (in case of ESM Demise).
(vii) Enter the Family Pensioner Details in the preceding columns (in case of ESM
Demise).
(viii) Enter details as required in the preceding columns.
(ix) Select Regional Centre, then select Polyclinic from the available options as
per your address of residence and Station HQ will be auto populated.
(x) Enter your permanent address, select district, tehsil and pin code.
(xi) Check in the tab to enter your Current Address if different from Permanent
Address.
20
(xii) Entering Old Smart Card number of primary member and attaching a copy of
the same is mandatory requirement.
(d) For Dependents.
(i) Upload recent passport size photograph and photo of signature/thumb
impression of the dependent by clicking on the tabs.
(ii) Enter details in respect of dependent as required in the preceding columns.
(iii) Follow same procedure for addition of all the dependents.
(iv) Details in the application can be edited any time before submission.
(v) Dependent if added erroneously can be deleted before submission of form.
(e) Attachments.
(i) Discharge book copy.
(ii) PPO copy.
(iii) Death certificate of ESM (only in case of ESM demise).
(iv) Disability Medical Certificate (In case of PWD).
(v) Old Smart Card copy.
(vi) Affidavit for Dependent.
(vii) Birth Certificate / Matriculation certificate (In case of dependent brother / sister).
(viii) Self attestation proforma (In case of children above 18 years of age excluding
children with White Cards).
(ix) On successful filling of Detailed Application, a message will be displayed that
Detailed Application filled up successfully proceed for Payment.
(f) Payment.
(i) You will be directed to a new window for payment for ECHS Smart Cards.
Please note that the cost of one Smart Card is Rs. 177/- (inclusive of all taxes)
plus transaction charges extra (as applicable). Separate card will be needed for
all members.
(ii) Select mode of payment and proceed as directed.
(iii) On successful payment, a confirmation SMS is forwarded to the registered
mobile number of primary beneficiary along with an Application number.
(g) Observation by Record Office.
(i) In case of any observation raised by your Record Office, the application will be
reverted back to you for correction. You will get an intimation SMS regarding
observations by Record Office.
(ii) Observations raised by the Record Office will be spelt out in your login.
(iii) Correct the observations and re-submit the application to Record Office for
further processing of Smart Card application.
21
CHAPTER – 4
GUIDELINES & INSTRUCTIONS FOR FILLING UP OF ECHS SMART CARD
ONLINE APPLICATION FORM – 1 APR 1996 – 31 MAR 2003 PENSIONERS
1. 1 APR 1996 – 31 MAR 2003 PENSIONERS. Ex-servicemen who retired / discharged from
service between 1 Apr 1996 to 31 Mar 2003 will be covered under this category. Those pensioners
who wish to become a member of ECHS will apply under this category. They are required to fill the
online Smart Card Application under Pre 1
st
Apr 2003 category thereafter select category 1 Apr 1996
to 31 Mar 2003 available on the online portal.
(a) Registration Process.
(i) Visit ECHS website http://www.echs.gov.in then click on the tab Online Smart
Card Application – Online Application.
(ii) Enter your name, service number along with valid mobile number and e-mail ID
(for receiving One Time Password) and new password then click on tab Register.
(iii) Verify your e-mail ID with the OTP received on your mail.
(iv) Verify your mobile number with the OTP received on your mobile.
(v) Registration process is complete after successful mobile OTP verification.
(vi) After successful registration a message will be displayed that Registration
Process successful proceed for Eligibility Check Process. One can login any time
using registered e-mail ID and password to fill the online ECHS smart card application
by clicking Already Registered Click to Login.
(vii) The Registration details will be valid only for a period of 15 days, if the
application is not filled completely and payment is not done for Smart Card. After 15
days period previous registration will expire and a new registration process has to be
followed.
(b) Eligibility Check Process.
(i) Click on the tab ‘Pre 1
st
Apr 2003 Retiree’
(ii) Click on the tab ‘1st Apr 1996 – 31
st
Mar 2003 Pensioners’
(iii) Select your Disability details (if any).
(iv) Select your citizenship, state then enter your Aadhaar number and Date of Birth.
(v) To add dependents, click on the ‘Add Dependent’ button.
(vi) Enter the Dependent Name, Dependent Relation, Dependent Date of Birth,
Dependent Marital Status, Dependent Monthly Income, Dependent Mobile Number,
Dependent Email ID, Dependent Disability Details (if any), Dependent Postal Address,
if same as primary beneficiary then select Address same as Primary Beneficiaries
Current Address else enter address of dependent, enter Dependent Aadhaar Number.
22
(vii) For white card eligibility, select physical disability as per The Person With
Disabilities, PWD Act 1995 from the drop down menu. Attaching of scanned copy of
medical certificate by service specialist as per format provided is a mandatory
requirement. Please note if the certificate has been issued based on ailment same is
NOT valid irrespective who has signed.
(viii) In case no other dependents need to be added, click on ‘If No Dependents
then Proceed to Verification’ button, else click on the ‘Add Dependent’ button to add
more dependents and follow steps (v) and (vi).
(ix) In case of any discrepancies in the eligibility criteria of any dependent, a
message will be displayed and respective field will be highlighted. Check and correct
the same for proceeding further to verification process.
(ix) On successful verification, a message will be displayed that Eligibility Check
completed successfully, proceed for Detailed Application.
(c) Detailed Application
(i) Click on the photo tab and upload your recent passport size photograph in civil
dress.
(ii) Select Gender, Date of Commission / Enrolment, Date of
Retirement/Release, Type of Pension, Type of Service, Category, Rank, Last unit
served, Record Office, PPO Number.
(iii) Click on signature tab and upload a photo of your signature.
(iv) If disability was selected, then enter your disability percentage. It should be 40%
or more.
(v) Click on the Family Pensioner photo tab and upload your recent passport size
photograph (in case of ESM Demise).
(vi) Click on Family Pensioner signature tab and upload a scanned copy of your
signature (in case of ESM Demise).
(vii) Enter the Family Pensioner Details in the preceding columns (in case of ESM
Demise).
(viii) Enter details as required in the preceding columns.
(ix) Select Regional Centre, then select Polyclinic from the available options as
per your address of residence and Station HQ will be auto populated.
(x) Enter your permanent address, select district, tehsil and pin code.
(xi) Check in the tab to enter your Current Address if different from Permanent
Address.
(xii) Contribution towards ECHS membership fees is required to be paid through
Military Receivable Order (MRO) is mandatory. Copy of receipt of MRO is required to
be attached. Rates of Contribution wef 01 Jun 2009 (as per 6
th
CPC) are as under
(Subject to Revision):-
23
RATES OF Contribution
Rs 15,000/-
Rs 27,000/-
Rs 39,000/-
Rs 60,000/-
(xiii) Rates of contribution are subject to revision as per 7
th
CPC.
Note: (i) War Disabled Pensioners/War Widows/NOK of Battle Casualties are exempted
from paying ECHS subscription.
(ii) All pensioners who have retired prior to 01 Jan 1996 are exempted from paying
ECHS contribution.
(iii) Fixed medical Allowance will be stopped from date of ECHS membership.
(d) For Dependents.
(i) Upload recent passport size photograph and photo of signature/thumb
impression of the dependent by clicking on the tabs.
(ii) Enter details in respect of dependent as required in the preceding columns.
(iii) Follow same procedure for addition of all the dependents.
(iv) Details in the application can be edited any time before submission.
(v) Dependent if added erroneously can be deleted before submission of form.
(e) Attachments.
(i) Discharge book copy.
(ii) PPO copy.
(iii) Death certificate of ESM (only in case of ESM demise).
(iv) Disability Medical Certificate (In case of PWD).
(v) Affidavit for Dependent.
(vi) Birth Certificate / Matriculation certificate (In case of dependent brother / sister).
(vii) Self attestation proforma (In case of children above 18 years of age excluding
children with White Cards).
(viii) Receipt of MRO.
(ix) DPDO / Bankers Certificate for non-drawing of FMA (Appendix E).
24
(x) On successful filling of Detailed Application, a message will be displayed that
Detailed Application filled up successfully proceed for Payment.
(f) Payment.
(i) You will be directed to a new window for payment for ECHS Smart Cards.
Please note that the cost of one Smart Card is Rs. 177/- (inclusive of all taxes)
plus transaction charges extra (as applicable). Separate card will be needed for
all members.
(ii) Select mode of payment and proceed as directed.
(iii) On successful payment a confirmation SMS is forwarded to the registered
mobile number of primary beneficiary along with an Application number.
(iv) A message is displayed Payment successful, Proceed for Temporary Slip
Generation.
(g) Temporary Slip.
(i) Online generated Temporary slip is required to be taken to nearest polyclinic for
activation along with all related service documents for ECHS membership. Temporary
Slip will be signed by OIC Polyclinic only after physical verification of the documents (in
original).
(ii) Temporary slip can be used in the interim period for availing ECHS facilities till
the issue of ECHS Smart Card.
(iii) On receipt of Smart Cards at Station HQ, intimation SMS will be forwarded to
your registered mobile number. The Smart Cards are required to be collected by every
dependent in person from Station HQ with deposit of Temporary slip.
(h) Observations by Record Office.
(i) In case of any observation raised by your Record Office, the application will be
reverted back to you for correction. You will get an intimation SMS regarding
observations by Record Office.
(ii) Observations raised by the Record Office will be spelt out in your login.
(iii) Correct the observations and re-submit the application to Record Office for
further processing of Smart Card application.
25
CHAPTER – 5
GUIDELINES & INSTRUCTIONS FOR FILLING UP OF ECHS SMART CARD
ONLINE APPLICATION FORM – PRE 1
ST
APR 1996 PENSIONERS
1. PRE 1
ST
APR 1996 PENSIONERS. Ex-servicemen who retried / discharged from service
prior to 1 Apr 1996 will be covered under this category. Those pensioners who wish to become a
member of ECHS will apply under this category. They are required to fill the online Smart Card
Application under Pre 1
st
Apr 2003 category thereafter select category Pre 1 Apr 1996 available on
the online portal.
(a) Registration Process.
(i) Visit ECHS website http://www.echs.gov.in then click on the tab Online Smart
Card Application – Online Application.
(ii) Enter your name, service number along with valid mobile number and e-mail ID
(for receiving One Time Password) and new password then click on tab Register.
(iii) Verify your e-mail ID with the OTP received on your mail.
(iv) Verify your mobile number with the OTP received on your mobile.
(v) Registration process is complete after successful mobile OTP verification.
(vi) After successful registration, a message will be displayed that Registration
Process successful proceed for Eligibility Check Process. One can login any time
using registered e-mail ID and password to fill the online ECHS smart card application
by clicking Already Registered Click to Login.
(vii) The Registration details will be valid only for a period of 15 days, if the
application is not filled completely and payment is not done for Smart Card. After 15
days period previous registration will expire and a new registration process has to be
followed.
(b) Eligibility Check Process.
(i) Click on the tab ‘Pre 1
st
Apr 2003 Retire’
(ii) Click on the tab ‘1st Apr 1996 Pensioners’
(iii) Select your Disability details (if any).
(iv) Select your citizenship, state then enter your Aadhaar number and Date of Birth.
(v) To add dependents, click on the ‘Add Dependent’ button.
(vi) Enter the Dependent Name, Dependent Relation, Dependent Date of Birth,
Dependent Marital Status, Dependent Monthly Income, Dependent Mobile Number,
Dependent Email ID, Dependent Disability Details (if any), Dependent Postal Address,
if same as primary beneficiary then select Address same as Primary Beneficiaries
Current Address else enter address of dependent, enter Dependent Aadhaar Number.
26
(vii) For white card eligibility, select physical disability as per The Person With
Disabilities, PWD Act 1995 from the drop down menu. Attaching of scanned copy of
medical certificate by service specialist as per format provided is a mandatory
requirement. Please note if the certificate has been issued based on ailment same is
NOT valid irrespective who has signed.
(viii) In case no other dependents need to be added click on ‘If No Dependents then
Proceed to Verification’ button, else click on the ‘Add Dependent’ button to add more
dependents and follow steps (v) and (vi).
(ix) In case of any discrepancies in the eligibility criteria of any dependent, a
message will be displayed and respective field will be highlighted. Check and correct
the same for proceeding further to verification process.
(x) On successful verification, a message will be displayed that Eligibility Check
completed successfully, proceed for Detailed Application.
(c) Detailed Application.
(i) Click on the photo tab and upload your recent passport size photograph in civil
dress.
(ii) Select Gender, Date of Commission / Enrolment, Date of
Retirement/Release, Type of Pension, Type of Service, Category, Rank, Last unit
served, Record Office, PPO Number.
(iii) Click on signature tab and upload a photo of your signature.
(iv) If disability was selected, then enter your disability percentage. It should be 40%
or more.
(v) Click on the Family Pensioner photo tab and upload your recent passport size
photograph (in case of ESM Demise).
(vi) Click on Family Pensioner signature tab and upload a scanned copy of your
signature (in case of ESM Demise).
(vii) Enter the Family Pensioner Details in the preceding columns (in case of ESM
Demise).
(viii) Enter details as required in the preceding columns.
(ix) Select Regional Centre, then select Polyclinic from the available options as
per your address of residence and Station HQ will be auto populated.
(x) Enter your permanent address, select district, tehsil and pin code.
(xi) Check in the tab to enter your Current Address if different from Permanent
Address.
(d) For Dependents.
(i) Upload recent passport size photograph and photo of signature/thumb
impression of the dependent by clicking on the tabs.
27
(ii) Enter details in respect of dependent as required in the preceding columns.
(iii) Follow same procedure for addition of all the dependents.
(iv) Details in the application can be edited any time before submission.
(v) Dependent if added erroneously can be deleted before submission of form.
(e) Attachments.
(i) Discharge book copy.
(ii) PPO copy.
(iii) Death certificate of ESM (only in case of ESM demise).
(iv) Disability Medical Certificate (In case of PWD).
(v) Old Temporary Slip copy.
(vi) Affidavit for Dependent
(vii) Birth Certificate / Matriculation certificate (In case of dependent brother / sister)
(viii) Self attestation proforma (In case of children above 18 years of age excluding
children with White Cards).
(ix) DPDO / Bankers Certificate for non-drawing of FMA.
(x) On successful filling of Detailed Application a message will be displayed that
Detailed Application filled up successfully proceed for Payment.
(f) Payment.
(i) You will be directed to a new window for payment for ECHS Smart Cards.
Please note that the cost of one Smart Card is Rs. 177/- (inclusive of all taxes)
plus transaction charges extra (as applicable). Separate card will be needed for
all members.
(ii) Select mode of payment and proceed as directed.
(iii) On successful payment a confirmation SMS is forwarded to the registered
mobile number of primary beneficiary along with an Application number.
(iv) A message is displayed Payment successful, Proceed for Temporary Slip
Generation.
(g) Temporary Slip.
(i) Online generated Temporary slip is required to be taken to nearest polyclinic for
activation along with all related service documents for ECHS membership. Temporary
Slip will be signed by OIC Polyclinic only after physical verification of the documents (in
original).
28
(ii) Temporary slip can be used in the interim period for availing ECHS facilities till
the issue of ECHS Smart Card.
(iii) On receipt of Smart Cards at Station HQ an intimation SMS will be forwarded to
your registered mobile number. The Smart Cards are required to be collected by every
dependent in person from Station HQ with deposit of Temporary slip.
(h) Observations by Record Office.
(i) In case of any observation raised by your Record Office, the application will be
reverted back to you for correction. You will get an intimation SMS regarding
observations by Record Office.
(ii) Observations raised by the Record Office will be spelt out in your login.
(iii) Correct the observations and re-submit the application to Record Office for
further processing of Smart Card application.
29
CHAPTER – 6
INSTRUCTIONS FOR COLLECTION & ACTIVATION OF SMART CARD
1. Collection of Smart Card. The Smart Cards will be dispatched to the concerned Station HQ
of the ECHS beneficiaries as per details filled in by the applicant. The following procedure is to be
followed by ECHS beneficiaries for collection of ECHs Smart Cards from Station HQs:-
(a) On receipt of Smart Cards at Station HQ an intimation SMS will be forwarded to the
registered mobile number of primary beneficiary.
(b) Approach to Station HQ along with all relevant documents submitted with online
application.
(c) The Smart Cards are required to be collected by each beneficiary in person from
Station HQ.
(d) Deposit all old Smart Card / Temporary Slips for receiving New Smart Cards.
2. Responsibility of Station HQ. Station HQs will receive package of Smart Cards from the
Regional Centre. On receipt of Smart Cards at Station HQ the following procedure is to be adopted
by the Station HQs:-
(i) On receipt of package, check and count the number of Smart Cards physically.
(ii) Login to online application and follow the instructions as laid down in Chapter – 4 of
Part – III of this document.
(iii) Maintain a register for issue of Smart Cards to beneficiaries.
(iv) Verify documents of the ECHS beneficiaries regarding eligibility.
(v) Receive old Smart Card / Temporary Slip from the beneficiary before issuing of new
Cards. In no case, new Smart Cards will be handed over to beneficiaries before
collecting old smart cards / temp slip.
(vi) Each card will be handed over to each beneficiary in person on their physical
availability. In no case, the card will be handed over to any other person.
(vii) Obtain signature of each beneficiary in the register against their names while handing
over the card.
(viii) The authenticity of each beneficiary has to be verified through service documents,
Aadhaar Card, PAN Card of the beneficiary.
(ix) A record for all old cards / slips withdrawn from beneficiaries is to maintained. The
withdrawn cards / slips will be later on destroyed under BOO.
3. Activation of Smart Card. The Smart Cards received from Station HQs are required to be
activated before availing the ECHS facilities at Polyclinics. Every Smart Card is required to be
activated using registered mobile number against that card.
30
4. Procedure for Activation of Smart Card.
(i) On receipt of SMS regarding collection of Smart Cards from Station HQs, a mobile
number will be provided in the same SMS.
(ii) Forward a SMS from each registered mobile number against card to this number in the
format <ACTIVATE><SPACE><CARD No>.
(iii) A confirmation SMS will be forwarded to your registered mobile number regarding
activation of Smart Card.
5. Conclusion. The whole system of Smart Card has been made online system from filling of
application to payment to verification of applications by Record Offices. The memory of card has
been enhanced from 32 to 64 Kbs, accordingly, larger number of transactions, details of medical
history including issue of drugs and equipments can now be stored on the card. Any fraudulent
cases detected or reported will invite permanent cancellation of ECHS membership and
punitive actions.
31
PART - III
32
CHAPTER - 1
GUIDELINES & INSTRUCTIONS TO ECHS FUNCTIONARIES – CENTRAL ORGANISATION ECHS
1. Verification of ECHS application form at Central Org ECHS for White Card and Special
Cases like Marital Discord.
(a) Insert Access Key Token/Digital Signature into the system. Instruction for obtaining
Digital Signature, registration and activation are enumerated at Para 2 below.
(b) Run the Client Utility from the desktop.
(c) Open the online application on website http://www.echs.gov.in then click on the tab
Online Smart Card Application – Central Organisation.
(d) Enter Pin for your Token.
(e) Enter User Password.
(f) Click on login to ECHS button.
(g) List of pending application will appear on the screen.
(h) Select application based on the application number and click on verify button to
proceed to verify.
(j) Check-list will appear on the screen, Cross the details on the checklist not matching the
records office data.
(k) Enter Remarks if any in the remarks Text Box.
(l) Once all records are compared and incorrect ones are crossed, click on “Verify
Records” button to proceed. The system will now send a SMS as well as an email to applicant
based on what has been done in verification.
(m) If you have selected “All Data Correct” – the applicant will get a SMS that the
application has been approved by Central Org.
(n) If you have selected “Edit Application Required” – the applicant will get a SMS as well
as and an email that the application has not been approved and the Applicant needs to edit
details as mentioned in the email. The user can then login onto application portal and edit
details as required.
(o) If you have selected “Require Records Clarification” – the applicant will get SMS as well
as an email that the application has not been approved and clarification is awaited from
Records. Records can Login and view list of clarifications asked by Central Org and write a
remark as response.
(p) Central Org can click on “Follow-up Details” Menu Option on Top of page to display list
of details of all responses pertaining to follow-up action done by Applicant or Records.
(q) Records can click on “Queries from Central Org” Menu Option on Top of page to
display list of details of all queries raised by Records and provide remarks and clarification on
the same.
33
2. Instructions for Process of Enrolment of Digital Signature Token.
(a) Director (Medical) and Joint Director (Medical) are authorised persons for Digitally
Signing verification of data for online application for White Cards. In case Central Org already
hold Class 3 Digital Signature Token they need to be registered as per instructions listed
below.
(b) In case Central Org ECHS is not having Digital Signature Token then two tokens one
each for Dir (Medical) and Jt Dir (Medical) has to be obtained from approved Certifying
Authority (CA).
(c) The CA should be approved by CCA India and are listed on NIC web site. For more
information on Digital Signature and how to obtain it visit http://www.cca.gov.in. For List of
approved CCAs you can visit http://www.cca.gov.in/cca/?q=licensed_ca.html.
(d) The Digital Signature has to be Class 3 which can be used for Encryption and Signing.
(e) Once the token is received please write a mail to [email protected] & copy to
[email protected] requesting for enrollment from official email ID only, requests received
from personal email will not be entertained.
(f) A link will be sent on office email ID for enrollment along with required credentials to
login. Click on the link sent on your email Login and follow the instructions to enroll your token.
Install the ECHS Client sent along with the email on your system.
(g) You should have latest browser installed as old browsers and Internet Explorer are
not supported as they lack basic security protocols. Edge, Chrome, Firefox and Safari are
supported browsers.
(h) Insert your Digital Signature Token into your computer and install the driver which came
along with it. Once the Driver is installed and the ECHS Token Client is installed launch a
supported Browser and paste the link sent on your email in the address bar. A Login Page will
open. Enter your credentials as sent on your email. Once logged in click on Enroll Token
Option.
(j) A screen will appear prompting for Token Pin. Enter the Token pin as provided by your
CA along with the Digital Signature Token. Once a correct pin is entered the system will
display all certificates available on the Token. Select the Certificate provided by your CA
which you want to use for signing, enter login and other credentials and click on Enroll. If the
certificate meets the required condition the Digital Signature Certificate and all details are
entered correctly the Digital Signature and User will be enrolled.
(k) Once enrolled visit the website http://www.echs.gov.in then click on the tab Online
Smart Card Application – Central Organisation. Login with credentials you have entered
during enrollment and proceed. Now follow instructions for Central Organization Application
Usage.
(l) In case of any query / problems write to d[email protected] & copy to
[email protected] or call on Toll Free number 1800 114 115.
34
CHAPTER - 2
GUIDELINES & INSTRUCTIONS TO ECHS FUNCTIONARIES – RECORD OFFICE
1. Verifying ECHS Application Form at Record Offices.
(a) Insert Access Key Token/Digital Signature into the system. Instruction for obtaining
Digital Signature, Registration and Activation are enumerated at Para 2 below.
(b) Run the Client Utility from the desktop.
(c) Open the online application on website http://www.echs.gov.in then click on the tab
Online Smart Card Application – Record Office.
(d) Enter Pin for your Token.
(e) Enter User Password.
(f) Click on login to ECHS button.
(g) List of pending application will appear on the screen.
(h) Select application based on the application number and click on verify button to
proceed to verify.
(j) Check-list will appear on the screen, Cross the details on the checklist not matching the
records office data.
(k) Enter Remarks if any in the remarks Text Box.
(l) Once all records are compared and incorrect ones are crossed, click on “Verify
Records” button to proceed. The system will now send email to applicant based on what has
been done in verification.
(m) If you have selected “All Data Correct” – the applicant will get a SMS that the
application has been approved by Records.
(n) If you have selected “Edit Application Required” – the applicant will get a SMS as well
as and an email that the application has not been approved and the Applicant needs to edit
details as mentioned in the email. The user can then login onto application portal and edit
details as required.
(o) If you have selected “Require Central Org Clarification” – the applicant will get SMS as
well as an email that the application has not been approved and clarification is awaited from
Central Org. Central Org can Login and view list of clarifications asked by Records and write a
remark as response.
(p) Records can click on “Follow-up Details” Menu Option on Top of page to display list of
details of all responses pertaining to follow-up action done by Applicant or Central Org.
(q) Records can click on “Queries from Central Org” Menu Option on Top of page to
display list of details of all queries raised by Central Org and provide remarks and clarification
on the same.
35
2. Instructions for Process of Enrolment of Digital Signature Token.
(a) Each Record Officer should nominate at least two authorised persons for Digitally
Signed Verification of data on the online application form. In case the Record Office already
holds Class 3 Digital Signature Token they need to be registered as per instructions listed
below.
(b) In case the Record Office is not having Digital Signature Token then two tokens has to
be obtained from approved Certifying Authority (CA).
(c) The CA should be approved by CCA India and are listed on NIC web site. For more
information on Digital Signature and how to obtain it visit http://www.cca.gov.in. For List of
approved CCAs you can visit http://www.cca.gov.in/cca/?q=licensed_ca.html.
(d) The Digital Signature has to be Class 3 which can be used for Encryption and Signing.
(e) Once the token is received please write a mail to [email protected] & copy to
[email protected] requesting for enrollment from official email ID only, requests received
from personal email will not be entertained.
(f) A link will be sent on office email ID for enrollment along with required credentials to
login. Click on the link sent on your email Login and follow the instructions to enroll your token.
Install the ECHS Client sent along with the email on your system.
(g) You should have latest browser installed as old browsers and Internet Explorer are
not supported as they lack basic security protocols. Edge, Chrome, Firefox and Safari are
supported browsers.
(h) Insert your Digital Signature Token into your computer and install the driver which came
along with it. Once the Driver is Installed and the ECHS Token Client is Installed launch a
supported Browser and paste the link sent on your email in the address bar. A Login Page will
open. Enter your credentials as sent on your email. Once logged in click on Enroll Token
Option.
(j) A screen will appear prompting for Token Pin. Enter the Token pin as provided by your
CA along with the Digital Signature Token. Once a correct pin is entered the system will
display all certificates available on the Token. Select the Certificate provided by your CA
which you want to use for signing, enter login and other credentials and click on Enroll. If the
certificate meets the required condition the Digital Signature Certificate and all details are
entered correctly the Digital Signature and User will be enrolled.
(k) Once enrolled visit the following website http://www.echs.gov.in then click on the tab
Online Smart Card Application – Record Office. Login with credentials you have entered
during enrollment and proceed. Now follow instructions for Record Office Application Usage.
(l) In case of any query / problems write to d[email protected] & copy to
[email protected] or call on Toll Free number 1800 114 115.
36
CHAPTER - 3
GUIDELINES & INSTRUCTIONS TO ECHS FUNCTIONARIES – REGIONAL CENTRE
1. Guidelines For Verifying ECHS Application Form, Receipt and Despatch of Smart Cards.
(a) Insert Access Key Token/Digital Signature into the system. Instruction for obtaining
Digital Signature, Registration and Activation are enumerated at Para 2 below.
(b) Run the Client Utility from the desktop. Open the online application on website
http://www.echs.gov.in then click on the tab Online Smart Card Application – Regional Centre.
Enter ECHS Access Key Token Password. Enter User Password. Click on Login to ECHS
button.
(c) List of Option will appear on the screen.
(i) Verify Application – Marital Discord or Any Special Case.
(aa) Click on Verify Application for application verification.
(ab) List of application will appear on the screen.
(ac) Select application based on the application number and click on verify
button to proceed to verify.
(ad) Check-list will appear on the screen, tick the details on the checklist
matching the records office data.
(ae) Application will be verified if all the details matches with the records office
data.
(af) In-case the data is not matched the system will generate automatic
remarks.
(ag) Click on verify button to save the details.
(ii) RC Package Receipt.
(aa) Click on RC Package Receipt Entry for entering the details of the cards
received.
(ab) An Entry form will appear.
(ac) Select tracking id from the dropdown list. List of all packets will be loaded
Station HQs wise based on the tracking id.
(ad) Enter remarks if any.
(ae) Tick the checkbox if the packet is received.
(af) Click on Save Button to save the details.
37
(ag) Click on cancel button to close the form.
(iii) Despatch to STN HQ.
(aa) Click on Despatch Card to STNHQ icon to open the entry form for
despatch entry.
(ab) Enter internal docket number.
(ac) Select Station Headquarter from the drop down list.
(ad) Attach scanned copy of the docket document.
(ae) All the cards related to the selected station headquarter will be loaded into
the form.
(af) Click on save button to save the details.
(ag) Click on cancel button to close the form.
2. Instructions for Process of Enrolment of Digital Signature Token.
(a) Director (Regional Centre) and Joint Director (Est) are authorised persons for Digitally
Signing verification of data for online application and for receipt and despatch of Smart Cards
respectively. In case Regional Centres already hold Class 3 Digital Signature Token they need
to be registered as per instructions listed below.
(b) In case Regional Centre ECHS is not having Digital Signature Token then two tokens
one each for Dir (RC) and Jt Dir (Est) has to be obtained from approved Certifying Authority
(CA).
(c) The CA should be approved by CCA India and are listed on NIC web site. For more
information on Digital Signature and how to obtain it visit http://www.cca.gov.in. For List of
approved CCAs you can visit http://www.cca.gov.in/cca/?q=licensed_ca.html.
(d) The Digital Signature has to be Class 3 which can be used for Encryption and Signing.
(e) Once the token is received please write a mail to [email protected] & copy to
[email protected] requesting for enrollment from official email ID only, requests received
from personal email will not be entertained.
(f) A link will be sent on office email ID for enrollment along with required credentials to
login. Click on the link sent on your email Login and follow the instructions to enroll your token.
Install the ECHS Client sent along with the email on your system.
(g) You should have latest browser installed as old browsers and Internet Explorer are
not supported as they lack basic security protocols. Edge, Chrome, Firefox and Safari are
supported browsers.
(h) Insert your Digital Signature Token into your computer and install the driver which came
along with it. Once the Driver is Installed and the ECHS Token Client is Installed launch a
supported Browser and paste the link sent on your email in the address bar. A Login Page will
open. Enter your credentials as sent on your email. Once logged in click on Enroll Token
Option.
38
(j) A screen will appear prompting for Token Pin. Enter the Token pin as provided by your
CA along with the Digital Signature Token. Once a correct pin is entered the system will
display all certificates available on the Token. Select the Certificate provided by your CA
which you want to use for signing, enter login and other credentials and click on Enroll. If the
certificate meets the required condition the Digital Signature Certificate and all details are
entered correctly the Digital Signature and User will be enrolled.
(k) Once enrolled visit the following website http://www.echs.gov.in then click on the tab
Online Smart Card Application – Regional Centre. Login with credentials you have entered
during enrollment and proceed. Now follow instructions for Record Office Application Usage.
(l) In case of any query / problems write to d[email protected] & copy to
[email protected] or call on Toll Free number 1800 114 115.
39
CHAPTER - 4
GUIDELINES & INSTRUCTIONS TO ECHS FUNCTIONARIES – STATION HEADQUARTERS
1. Guidelines for Verifying ECHS Application Form
(a) Insert Access Key Token/Digital Signature into the system. Instruction for obtaining
Digital Signature, Registration and Activation are enumerated at Para 2 below.
(b) Run the Client Utility from the desktop. Open the online application on website
http://www.echs.gov.in then click on the tab Online Smart Card Application – Station HQ.
Enter ECHS Access Key Token Password. Enter User Password. Click on Login to ECHS
button.
(c) List of Option will appear on the screen.
(i) Verify Application – For Dependent Brother / Sister, Marital Discord or Any
Special Case
(aa) Click on Verify Application for application verification.
(ab) List of application will appear on the screen.
(ac) Select application based on the application number and click on verify
button to proceed to verify.
(ad) Check-list will appear on the screen, tick the details on the checklist
matching the records office data.
(ae) Application will be verified if all the details matches with the records office
data.
(af) In-case the data is not matched the system will generate automatic
remarks.
(ag) Click on verify button to save the details.
(ii) Station HQ Card Receipt
(aa) Click on Package Receipt Entry for entering the details of the cards
received.
(ab) An Entry form will appear.
(ac) Select tracking id from the dropdown list. List of all card will be loaded
based on the tracking id.
(ad) Enter remarks if any.
(ae) Tick the checkbox if the card is received.
(af) Click on Save Button to save the details.
40
(ag) Click on cancel button to close the form.
(iii) Station HQ Card Handing Over
(aa) Click on card handing over icon to open the entry form for handing over
the cards to the beneficiary.
(ab) Enter card number of the beneficiary who comes to receive the cards.
(ac) All the cards related to the beneficiary will be loaded into the form.
(ad) Tick the checkbox to select the card.
(ae) Click on save button to save the details.
(af) Obtain signature of each beneficiary in the register while handing over the
Smart card.
(ag) All previous cards / temporary slips will be withdrawn prior to handing
over new cards and records to be maintained. All old cards / slips will be later
on destroyed under BOO.
2. Instructions for Process of Enrolment of Digital Signature Token.
(a) SO ECHS, Station Headquarter is authorised person for Digitally Signing verification of
data for online application and for receipt and despatch of Smart Cards. In case Regional
Centres already hold Class 3 Digital Signature Token they need to be registered as per
instructions listed below.
(b) In case SO ECHS, Station Headquarter is not having Digital Signature Token then one
token for has to be obtained from approved Certifying Authority (CA).
(c) The CA should be approved by CCA India and are listed on NIC web site. For more
information on Digital Signature and how to obtain it visit http://www.cca.gov.in. For List of
approved CCAs you can visit http://www.cca.gov.in/cca/?q=licensed_ca.html.
(d) The Digital Signature has to be Class 3 which can be used for Encryption and Signing.
(e) Once the token is received please write a mail to [email protected] & copy to
[email protected] requesting for enrollment from official email ID only, requests received
from personal email will not be entertained.
(f) A link will be sent on office email ID for enrollment along with required credentials to
login. Click on the link sent on your email Login and follow the instructions to enroll your token.
Install the ECHS Client sent along with the email on your system.
(g) You should have latest browser installed as old browsers and Internet Explorer are
not supported as they lack basic security protocols. Edge, Chrome, Firefox and Safari are
supported browsers.
(h) Insert your Digital Signature Token into your computer and install the driver which came
along with it. Once the Driver is Installed and the ECHS Token Client is Installed launch a
supported Browser and paste the link sent on your email in the address bar. A Login Page will
open. Enter your credentials as sent on your email. Once logged in click on Enroll Token
Option.
41
(j) A screen will appear prompting for Token Pin. Enter the Token pin as provided by your
CA along with the Digital Signature Token. Once a correct pin is entered the system will
display all certificates available on the Token. Select the Certificate provided by your CA
which you want to use for signing, enter login and other credentials and click on Enroll. If the
certificate meets the required condition the Digital Signature Certificate and all details are
entered correctly the Digital Signature and User will be enrolled.
(k) Once enrolled visit the following website http://www.echs.gov.in then click on the tab
Online Smart Card Application – Station HQ. Login with credentials you have entered during
enrollment and proceed. Now follow instructions for Record Office Application Usage.
(l) In case of any query / problems write to d[email protected] & copy to
[email protected] or call on Toll Free number 1800-114-115.
42
CHAPTER - 5
GUIDELINES & INSTRUCTIONS TO ECHS FUNCTIONARIES – POLYCLINIC
1. Change of mobile number of Primary Beneficiary / ESM
(a) Open the online application on website http://www.echs.gov.in then click on the tab
Online Smart Card Application – Polyclinic.
(b) Enter User ID, User Password and Click on login button.
(c) Select Change Mobile No Requests from Menu.
(d) A list of all requests for change of mobile number will appear in next window.
(e) Click on the Action button for ESM approaching for change of mobile number.
(f) A new window with all details of the ESM along with photo will appear on the screen.
(g) Verify details with Smart Card.
(h) Enter new mobile number, re-enter new mobile number, click on Get OTP, enter OTP
received on ESMs new mobile number, click on Submit button.
(j) A confirmation message will appear on screen along with a confirmation SMS on new
mobile number of ESM.
2. Unblocking of Smart Cards of Children above 18 years of age.
(a) Open the online application on website http://www.echs.gov.in then click on the tab
Online Smart Card Application – Polyclinic.
(b) Enter User ID, User Password and Click on login button.
(c) Select Unblock Smart Card from Menu.
(d) A list of all requests for unblocking of Smart Card for children above 18 years will
appear in next window.
(e) Click on the Action button for beneficiary approaching for unblocking of card.
(f) A new window with all details of the beneficiary along with photo will appear on the
screen.
(g) Verify details of beneficiary with Smart Card.
(h) Click on button Unblock Card after ascertaining the eligibility of the beneficiary.
(j) A confirmation message will appear on screen along with a confirmation SMS on
beneficiary mobile number.
43
PART - IV
44
Appendix A
in lieu of IAFF (A) 507
MILITARY RECEIVABLE ORDER
Bank’s Counterfoil (To be forwarded to the CDA)
(To be filled in by MRO issuing authority)
Received a sum of Rs
Total (Rs in words)
From ………………………………..………………………………. (name of the individual/unit/office)
By Cash/Cheque No ………… Date ……….. Bank ……… for credit to PCDA/CDA ………………..
……………………………………… on account of ………………………………. as Defence receipts
(Signature of the Issuing Officer)
Unit/Officer
---------------------------------------------------------------------------------------------------------------------------------------------------------------
Depositor’s Counterfoil-1 (To be retained by the Depositor)
(To be filled up by Treasury/RBI/Bank)
Treasury/RBI/Bank ………………… Dated …..…………
Received a sum of Rs ……………….……………..(Rupees ……………….…………………. Only)from ……………….
(individual/Unit/Officer) on account of …………………….. for credit to PCDA/CDA……………… as Defence Receipt
-----------------------------------------------------------------------------------------------------------------------------------------------------------------
Depositor’s Counterfoil-2 (To be forwarded to PCDA/CDA)
(To be filled up by Treasury/RBI/Bank)
Dated ..………
Treasury/RBI/Bank …………………
Received a sum of Rs ……………….…………….. (Rupees ……………….…………………. Only) from………….….
(individual/Unit/Officer) on account of …………………….. for credit to PCDA/CDA ………………………… as Defence
Receipt
----------------------------------------------------------------------------------------------------------------------------------------------------------------
Depositor’s Counterfoil-3 (To be retained by Stn HQ/Regional Centre)
(To be filled up by Treasury/RBI/Bank)
Dated ..………
Treasury/RBI/Bank …………………
Received a sum of Rs ……………….…………….. (Rupees ……………….…………………. Only) from………….…..
(individual/Unit/Officer) on account of …………………….. for credit to PCDA/CDA ………………………… as Defence
Receipt
----- Crores
------ lakhs
--- thousands
---- hundreds
------ Tens
------ units
ens
BSR Code
D D M M Y Y
Serial No
Bank Seal
BSR Code
D D M M Y Y
Serial No
Bank Seal
BSR Code
D D M M Y Y
Serial No
Bank Seal
BSR Code
D D M M Y Y
Serial No
Bank Seal
45
Appendix B
SAMPLE OF AFFIDAVIT
(For initial application)
AFFIDAVIT ON Rs. 10/- NON JUDICIAL STAMP PAPER and TO BE ATTESTED BY MAGISTRATE/NOTARY
PUBLIC DECLARATION
I Service No ________________ Rank ________ Name _____________________ (Unit)
______________, solemnly affirm and declare as follows:-
or
I,________________ wife/Father/Mother/Daughter/Son Service No _______________ Rank ______
Name__________________________ of (unit) _________________________________ solemnly
affirm and declare as follows:-
1. That I am/will be drawing pension vide PCDA Pension Payment Order
No______________________________ dated___________________
2. That I have the following legal dependent(s) whose photograph(s) is/are affixed below on this
Affidavit :-
Name Relationship Age Date of Birth Part II Order No/CRD/SD/POR No
Signed Photo of Dependent giving name, Signed Photo of Dependent giving name,
Relationship and Identification mark Relationship and Identification mark
(Photographs(s) to be pasted and signed across by the Applicant)
3. (a) That the combined monthly income (from all sources including income accruing from
house/other immovable property/fixed deposit etc) of my dependant father and /or dependent
mother is less than Rs 9000/- plus DA.
(b) That is hereby certified that my parents (father/mother or both) do not draw any pension
from Central Govt/State Govt/PSUs/any Private Organisation and are physically residing with
me.
4. That my child/ children is/are dependent on me and is/are NOT earning more than Rs. 9000/-
plus DA per month, & that my daughter(s) is/are NOT married or is divorced and fully dependent on
me.
5. I shall inform the ECHS immediately of his/her/their employment of earning more than
Rs 9000/- plus DA.
6. That in case of any change in the status of my dependants (due to death, marriage,
employment), I will inform Station Headquarters, ECHS Cell at the earliest and will stop use of ECHS
facilities. I will refund in full, the cost of any treatment that my dependent may have received after
he/she became ineligible. I shall be liable for civil/criminal action should I fail to do so.
7. (a) That I am NOT a member of any other medical scheme funded by Central Govt, PSU
or any other Govt undertaking.
(b) That my spouse is NOT a member CGHS or any other Govt Scheme.
8. I understand that in case I have submitted any incorrect information, or if any ECHS
Membership Card is misused or used by any unauthorised person, my membership will be cancelled
without any notice or further hearing. In addition, I will forfeit my contribution and I will pay the entire
46
cost of expenditure incurred on such unauthorised person(s). I will also be liable for legal action by
the ECHS Organisation. I will also immediately report the loss of my ECHS membership card to the
nearest Station Headquarters.
9. That in case of any misuse of Smart Cards(s) or tampering with bills or attempt to defraud,
once I become a member, I will forfeit my membership automatically.
10. I undertake that in case of any misbehavior, on my part with Polyclinic Staff, my membership
may be suspended/cancelled/ terminated.
11. I understand that the contribution I am making is a one time token amount and is not
refundable even if I do not make use of any ECHS facility or opt out of ECHS Scheme.
VERIFICATION
I, the deponent above named, do hereby solemnly declare and verify that the contents of the above
affidavit are true to the best of my knowledge and belief, and nothing material has been concealed or
suppressed therefrom.
Verified at (place)-----------------------on this (date)--------------day of (Month)------------------Year-----------
Signature of Deponent
ATTESTATION
Certified that the above statement is declared before me at (Place)---------on this ------------day of
(Month)----------Year--------by DEPONENT Service No ----------------Rank-----------Name--------------------
--------Who is identified by Name---------------------------------------S/O (Father’s name of Identifier)---------
------------------------- and witnessed by Name---------------------------------------S/O (Father’s name of first
witness)& Name------------------------------------- S/O (Father’s name of second witness).
WITNESS
Signature of Witness No.1 Signature of Witness No.2
(Name in Block Capitals) (Name in Block Capitals)
(Full Postal Address) (Full Postal Address
ATTESTED BY
MAGISTRATE/NOTARY PUBLIC
47
Appendix C
CERTIFICATE FOR PERSON WITH DISABILITY
Name & Address of the Institute/Hospital issuing the Certificate
Certificate No ………………… Date ……………….
Signature/ Thumb Impression of Patient
1. This is to certify that Shri / Smt / Kum ________________________ Age ____________ yr
Son/Daughter/Wife/ Widow of No _______________________ Rank
___________________________________ Name ______________________ Registration No
_____________________ dated _________________________ PPO NO
____________________________________ dated _______________________ is a case of
_______________________________________ with onset of disability at ____________ yrs of age.
2. He / She is physically / mentally/ visually / speech / hearing disabled and has __________ %
(____________________ percentage), disability of permanent / temporary nature.
3. This condition is progressive/non-progressive and is likely to improve/not likely to improve.
4. Re-assessment is not recommended/is recommended after a period of ______ Months/ Years.
5. He is above to / unable to earn his living.
Signature & Stamp of Signature and Stamp of
Specialist President Medical Board
COUNTERSIGNED
Commandant/CO/Head of Hospital (with Seal)
Recent photograph
showing the Disability
Affixed here to be
attested by concerned
specialist
48
Appendix D
ECHS SELF ATTESTED PROFORMA FOR DEPENDENT SON/DAUGHTER
ABOVE 18 YEARS OF AGE
2. Particulars of Dependent Master / Miss _______________________
(a) Date of Birth ________________________
(b) Aadhar No._________________________
(c) PAN No.___________________________
(d) Address____________________________
3. It is also certified that Master / Miss ______________________is not employed and is having no
income.
4. It is also certified that Master / Miss ______________________ is not married.
Note: The self attested proforma alongwith countersignature of OIC parent ECHS Polyclinic, will be produced
whenever required in ECHS polyclinic / empanelled hospital by the beneficiary. The validity of the same will
be ONE YEAR from the date of signature, after which dependents need to prepare a fresh proforma. In case
of any change in dependency, the primary card holder is responsible to cancel the membership of dependent
immediately on occurrence. Any false declaration / misuse of benefits will entail suspension /
cancellation of ECHS membership.
___________________________ __________________________
(Signature of Dependent) (Signature of Ex-serviceman /
Primary Member)
Date: ______________________ Place:_____________________
1. It is certified that Master / Miss ____________________________
whosePhotograph is appended is a bonafied dependent Son / Daughter of
No._________________ Rank _________ Name ____________________
(Retired) with ECHS Card / Receipt No._____________________________.
LATEST
SELF
ATTESTED
PHOTO
PP SIZE
49
Appendix E
DPDO/BANKER’S CERTIFICATE
Certified the following:
Ser. No ….….……………. Rank …….……….Name………………………………………………………
Pension Account No ………………………………………………………. of this Bank is drawing
Pension as follows:
(a) Uncommuted Basic Pension Rs. ………………………………………..
(b) Dearness Pension Rs. ……………………………………….
(50% of Basic Pension)
(c) DA Rs. ………………………………………
Rs. ……………………………………...
His Pension Payment Order No .is……………………………….……………………………………………
Fixed Medical Allowance has been stopped w.e.f. (date) ………………………………………………….
(Authority for discontinuation of FMA. CGDA New Delhi Circular No. 5601/AT-P/Paytt
dated 17 Jun 05 and GOI, MOD letter No. 2 (a) / 01/ US(WE)/D (Res) dated 30 Dec 2002)
Date ________________________ PDA/Bank manger/i/c DPDO
(With Official Stamp)