Bsnl retired employees medical reimbursement option form 2021-2026

1. Click ‘Get Form’ to open the bsnl retired employees medical reimbursement option form 2021 in the editor.
2. Begin by entering your personal details in the designated fields: Name of Employee, Designation, and Registration Number.
3. Next, input your Salary (Basic Pay + DA) or Pension as of April 1st in the appropriate section.
4. Fill in your Place of Duty and provide the Name of Patient along with their Relationship to you.
5. Indicate the Age of the patient and select the relevant reimbursement option by ticking the appropriate box for treatment type.
6. Detail the Nature of illness and provide the Name of Doctor or Hospital where treatment was received.
7. In the Details of claim section, attach necessary documents like prescriptions and vouchers. List each expense under Consultation, Diagnostics/Tests, Medicines, Appliances, Special treatment, and Others.
8. Finally, calculate and enter the Total amount claimed. Ensure to sign in the Declaration section confirming that all information is accurate.

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