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Form ESIC- MED 37/ESIC-MED 7A. BRO-266. This is a certificate for continuing in employment or re-employment and an application for acceptance of medical treatment. Note:This is used for the registration of temporary identity Card with the medical practitioner and to have the medical treatment.
Form 1 - This is a declaration form. Form 01 - Employer's registration form. Form 1A - Family declaration form. Form 142 - This form is used for making claims for compensation for loss of earnings and conveyance allowance.
The application Form may be downloaded from our website www.esic.nic.in and the application fee of Rs. 500/-(Non-refundable) be submitted by way of Demand Draft/Bankers Cheque in favour of ESI Fund A/c No.
ESIC Form 10 used for insured person not capabale for attend job during medical problem and take treatment from esic hospital.