Apply: Severe Illness Treatment Assistance (3 Years)

Original Documents to Present at Centre (5):

• Original Welfare Board Card
• Government Hospital / Specialist Doctor Medical Treatment Certificate
• Medical Treatment Discharge Summary & Lab Reports
• Ration Card & Aadhaar Card
• Active Bank Passbook

Applicant Information

Full Name * Please enter your full name

Mobile Number * Please enter a valid 10-digit Indian mobile number

Address

Door / Flat Number * Please enter your door or flat number

Street Address * Please enter your street name

City / Village * Please enter your town or city

District * Please select your district

State

Postal PIN Code * Please enter a valid 6-digit PIN code

Work Type * Please select your work type

Specify Your Work * Please specify your work

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