3/49711 /AG/ECHS
EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME (ECHS) APPLICATION FORM FOR MEMBERSHIP (REV 2015)
1. Ref Central Org ECHS letter No Bl49711/AG/ECHS dt 15 Jan 2015.
Encls :- As above
DETAILED INSTRUCTIONS FOR FILLING APPLICATION FORM
Grade Pay drawn at the time of retirement | RATES OF Contribution |
Rs 1800/-, Rs 1900/-, Rs 2000/-, Rs 2400/- and Rs 2800/- per month | Rs 15,000/- |
Rs 4200/- per month | Rs 27,000/- |
Rs 4600/-, Rs 4800/-, Rs 5400/- and Rs 6600/- per month | Rs 39,000/- |
Rs 7600/- and above per month | Rs 60,000/- |
MUST KNOW POINTS
DO’S | DON’T’S |
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AFFILIATION OF SERVICE HQS & RECORDS OFFICERS WITH ECHS REGIONAL CENTRES
Regional Centres | Affiliated Section at Service HQs & Records office |
Delhi Cantt
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Army HQs/AG’s Branch MP 5/6 and MPRS (O) – for Army officers : Naval headquarters.
DOP – for Naval Officers;;CGHQ-For Coast Guard officers /PBOR, RAJPUTANA RIFLES, Air Headquarters/ DPP & R – for Air force Officers; Air Force Records office (AFRO) – for all Air Force PBOR.
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Pune
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Armourd Corps; Regiment of Artillery; Army Air Defence; Mechanised Infantry; Bombay Engineer Group (BEG), Intelligence Corps; Army Physical Training Corps (APTC),
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Patna
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BIHAR Regiment;
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Lucknow
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RAJPUT Regiment; SIKH Light Infantry Regiment; 11 GORKHA RIFLES; Army Medical Corps (AMC);
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Hyderabad
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Army Ordnance Corps (AOC), Electronic and Mechanical Engineers (EME).
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Jabalpur
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Corps of Signals; GRENADIER Regiment; MAHAR Regiment; Jammu & Kashmir Rifles (JAK RIF);Army Education Crops (AEC),
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Jammu
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Jammu & Kashmir Light Infantry (JAK LI); LADAKH SCOUTS.
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Guwahati
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ASSAM Regiment; 5&8 GORKHA RIFLES.
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Chandimandir
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1 & 4 GORKHA RIFLES.
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Dehradun
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Bengal Engineer Group, GARHWAL RIFLES, Strategic Fighting Force Records.
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Bareilly
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JAT Regiment, KUMAON Regiment, Remount & Veterinary Corps (RVC).
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Allahabad
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3&9 GORKHA RIFLES, DOGRA Regiment.
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Ranchi
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PUNJAB Regiment, SIKH Regiment.
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Nagpur
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Brigade of Guards, Army Postal Service (APS).
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Mumbai
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CABS Mumbai.
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Bangalore
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MARATHALI, Madras Engineers Group (MEG), PARACHUTE Regiment, Army Service Corps (South), Army Service Corps (AT), Corps of Military Police (CMP), Pioneer Corps.
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Trivandrum
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Defence Security Corps (DSC).
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Coimbatore
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MADRAS Regiment.
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AFFIDAVIT ON Rs. 10/- NON JUDICIAL STAMP PAPER and TO BE ATTESTED BY MAGISTRATE/NOTARY PUBLIC DECLARATION
1. | That I am/will be drawing pension vide PCDA Pension Payment Order No______________________________dated___________________ |
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2. | That I have the following legal dependent(s) whose photograph(s) is/are affixed below on this Affidavit :- | ||||||||||
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(Photographs(s) to be pasted and signed across by the Applicant) |
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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 3500/- 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 dependant on me and is/are NOT earning more than Rs. 3500/- plus DA per month, & that my daughter(s) is/are NOT married. | ||||||||||
5. | I shall inform the ECHS immediately of his/her/their employment of earning more than Rs 3500/- 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 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. |
Signature of Witness No.1 | Signature of Witness No.2 |
1. (Name in Block Capitals) (Full Postal Address)
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1. (Name in Block Capitals) (Full Postal Address
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MAGISTRATE/NOTARY PUBLIC
INSTRUCTIONS FOR MILITARY RECEIVABLE ORDER (MRO)
Controller General of Defence Accounts (CGDA) has nominated the following Army Principal Controllers of Defence Accounts (PCsDA)/ Controllers of Defence Accounts (CsDA) for accounting the contribution made in their areas of jurisdiction.
Ser No | Regional Centre | Polyclinic under jurisdiction of Regional Centres | Name to be Entered in MRO Army PCDA CDA |
1. | Jammu | Bakloh, Akhnoor, Baramulla, Baribrahmna, Doda, Jammu, Junglot(Kathua), Leh, Pathankot, Poonch, Rajouri, Samba, Shahpur, Srnagar, Talwara, Uchi Bassi, Udhampur, Nagrota (Gujroo),Yol, Mandi, Chamba, Palampur, Kullu, Deragopipur,Kanabal | PCDA (NC) Jammu |
2. | Delhi West | Delhi Cantt (BHDC), New Delhi (Lodhi Road), Gurgaon, Shakurbasti, Nuh, Gurgaon(Sohan Road), Khanpur | PCDA (WC) Chandigarh |
3. | Delhi East | Noida, Timarpur, Faridabad, Ghaziabad(Hindon),Greater Noida, Palwal | PCDA (WC) Chandigarh |
4. | Chandimandir | Chandigarh, Chandimandir, Ropar, Sarkaghat, Mohali, Ludhiana, Jagraon, Sangrur, Patiala, Fatehgarh Sahib, Samana, Nabha, Barnala, Nawansahar, Shimla, Rampur | PCDA (WC) Chandigarh |
5. | Jaipur | Alwar, Behror, Hindaun City(Dist Karauli), Mahendragarh, Narnaul, Rewari, Dharuhera, Bharatpur, Bhuwana, Chirawa, Dausa, Jaipur, jhunjhunu, Nim Ka Thana, Sikar, Vidhyadhar Nagar(Sanganer), Kota | PCDA (SWC) Jaipur |
6. | Pune | South Pune(Lohegaon), Sindhudurg, Panaji, Sholapur, Ahmednagar, Beel, Latur, Osmanabad, Saugor, Karad, Kolhpur, pune, Orai, Jhansi, Morena, Gwalior, Bhind, Miraj (Sangli), Khadki (Pune), Buldana, jalgaon, Dhule, Devlali, Bhopal, Amravati, Akola | PCDA (SC) Pune |
7. | Lucknow | Akbarpur Matti (Kanpur Dehat), Unnao, Barabanki, Hardoi, Lakhimpur(UP), Lucknow, Raebareli, Etawah, Fatehgarh, Kanpur, Agra, Mainpuri, Etah, Barilly, Badaun, Sarsawa, Mathura, Meerut, Aligarh, Muzaffarnagar, Baghpat, Shahjanpur, Moradabad, Hathras, Bijnore, Bulandshshir, Firozabad, Rampur | PCDA (CC) Lucknow |
8. | Patna | Ara, Danapur(Patna), Darbhanga, khagaria, Madhubani, Motihari, Munger, Muzaffarpur, Samastipur, Sitamarhi, Siwan, Chhapra, Vaishali, Bhagalpur, Gaya, Sasaram, Buxar | CDA Patna |
9. | Jabalpur | Bilashpur, Raigarh, Indore, Mhow, Jabalpur, Satna, Raipur, Rewa, Jagdalpur,Pachmarhi | CDA Jabalpur |
10. | Hyderbad | Guntur, Secunderbad, Chittor, Giddalur, Golconda, Ananthapur, Cudapah, Eluru, Golconda, Karimnagar, khammam, Kurnool, Mehbubnagar, Nellore, Secunderabad2(Bownpally), Vijaywada | CDA Secunderabad |
11. | Chennai | Avadi, Chennai, Chennai(island Ground), Cuddolore, Kanchipuram, Thiruvannamalai, vellore, villupuram, Puducherry, Krishnagiri, Kumbhkonum, Nagapattinam, Thanjavur, Tambram | CDA Chennai |
12. | Kochi | Alleppey, Kottayam, Kunnamkulam, Thrissur, Iritti, Kalpetta, Kanhaged, Kannur, Perintalmanna, Kozhikode, Kochi, Moovattupuzha, Painavu, Palakkad | JCDA(Navy)Kochi |
13. | Guwahati | Agartala, Aizwal, Along, Lunglei, Bongaigaon, Dhubri, Churachandpur, Imphal(Leimakhong), Dibrugarh, Tinsukia, Dimapur, Goalpara, Gawahati, Jorhat, Mokokchung, Lakhimpur, Lanka, Masimpur, Misamari, shillong | CDA Guwahati |
14. | Allahabad | Allahabad, Pratapgarh, Fatepur, Banda, Azmgarh, Faizabad, Gonda, Sultanpur, Ballia, Ghazipur, Jaunpr, Mirzapur, Varanasi, Basi, Deoria, Gorakhpur, | PCDA (CC) Lucknow |
15. | Ambala | Ambala, Gohana, Kaithal, Karanal, Kharkhoda, Nrayangarh, Khurkshetra, Panipat, Sonepat, Yamunanagar, Nahan | PCDA (WC) Chandigarh |
16. | Coimbatore | Coimbatore, Dindigul, Madurai, Srivilliputur, Theni, Tiruchirapalli, Salem, Sivagangai, Wellington | JCDA (Air force) Nagpur |
17. | Dehradun | Almora, Bageswar, Ranidhet, Banbasa, Dehradun, Dharchula, Vikasnagar, Uttarkasi, Haldwani, Rudrapur, Hempur, Joshimath, Karanprayag( Gopeshwar), Rudraprayag, Kotdwara, Landsdowne, Pauri Garhwal, pithoragarh, Raiwala, Tehri, Roorkee | PCDA (CC) Lucknow |
18. | Hissar | Abohar, Bahadurgrah, Bhiwani, Charki Dadri, Didwana, Fatehabad, Hissar, Jhajjar, Jind, Kosli, Lohara, Meham, Narwana, Rohtak, Sampla, Bathinda, Mansa, Bikaner, Churu, Nagaur, Rajgarh, Siirsa,Sriganganagar, Suratgarh | PCDA (SWC) Jaipur |
19. | Nagpur | Amla, Nagpur, Wardha, Amravati, Akola, Yavatmal | JCDA (Air force) Nagpur |
20. | Visakhapatam | Angul, Balasore, Bhubneswar, Dhenkanal, Puri, Kakinada, Srikakulam,Vishakapatnam, Ramnathapuram, Port Blair | ACDA (Navy) Visakhapatanam |
21. | Mumbai | Mumbai, Chiplun, Mahad, karwar, Mumbai(Upnagar), Thane (Nerul), Vasco-da-gama, COD Kandivali | PCDA (Navy) Mumbai |
22. | Kolkata | Barrackpore, Salt lake, Midnapur, Kolkata, Baruipur, Howrah, Benguri, Bankura, Cooch Behar, Gangtok, Kalimpong, Katihar, Krishananagr, Katihar, Krishnanagar, Behrampur, lebong(Darjeeling) | CDA Guwahati |
23. | Ahmedabad | Ahmedabad, Ajmer, Barmer(Jalipa), Bhuj, Jaisalmer, Jamnagar, Jodhpur, Shergarh, Pali, Rajsamand, Dungarpur, Vadodra, Surat, Udaipur | PCDA (Air force) Dehradun |
24. | Bangalore | Bangalore, Hassan, Belgaum, Bijapur, Dharwad, Gulbarga, Bidar, Tumkur, Yeahanka(Bangalore), Kolar, Madekeri, Manglore, Shimoga, Virarajendrapet, meg Banglore, Mysore | JCDA (Air force) Nagpur |
25. | Barilly | Agra, Etah, Firozabad, Bagpat, Bijnor, Muzaffarnagar, Mainpuri, Meeurt,Hathras, Aligarh, Mathura, Moradabad, Rampur, Badaun, Barilly, Bulandshahar, Saharanpur(Sarsawa), Shahjanpur | PCDA Meerut |
26. | Jalandhar | Ajnala, Amritsar, Batala, Gudaspur, Beas, Bilaspur, Faridkot, Moga, Muktsar, Ferozpur, Garhshankarn (Mahalpur), Hamirpur, Una, Suranassi, Hoshiarpur, Ghumarvin, Barsar, Jalandhar,Kapurthala, Nawansahar, Phagwara, Sultanpuri Lodhi, Jogindernagar | PCDA (WC) Chandigarh |
27. | Ranchi | Behrampur, Bhawanipatna, Koraput, Sambalpur, Chaibasa, Dalatganj, Gumla, Ranchi, Dhanbad, Deogarh, Jamshedpur | CDA Patna |
28. | Trivandrum | Changanacherry, Kilimanur, Kottarakara, Mavelikara, Nagarcoil, Pathanamthitta, Ranni, Trivandrum, Trivandrum (Med College), Tuticorin, Quilon (Kollam), Tirunelvli | PCDA Chennai |
ABBREVIATED RANKS
OFFICERS
ARMY | Abbreviation | NAVY | Abbreviation | AIR FORCE | Abbreviation | Indian Coast Guard | Abbreviation |
General | Gen | Admiral | Adm | Air Chief Marshal | ACM | – | – |
Lieutenant General | Lt Gen | Vice Admiral/ Surg Vice Admiral | V Adm/ Surg V Adm | Air Marshal | Air Mshl | Director General | DG |
Major General | Maj Gen | Rear Admiral/ Surg Rear Admiral | R Adm/Surg R Adm | Air Vice Marshal | AVM | Inspector General | IG |
Brigadier | Brig | Commodore/ Surg Commodore | Cmde/ Surg Cmde | Air Commodore | Air Cmde | Dy Inspector | DIG |
Colonel | Col | Captain/Surg Captain | Capt (IN)/Surg Capt | Group Captain | Gp Capt | Commandant | Comdt |
Lieutenant Colonel | Lt Col | Commander/Surg Commander | Cdr/Surg Cdr | Wing Commander | Wg Cdr | Commandant (JG) | Comdt (JG) |
Major | Maj | Lt Commander/ Surg Lt Commander | Lt Cdr/ Surg Lt Cdr | Squadron Leader | Sqn Ldr | Dy Commandant | Dy Comdt |
Captain | Capt | Lt /Surg Lt | Lt (IN)/Surg Lt | Flight Lieutenant | Flt Lt | Asst Commandant | Asst Comdt |
Lieutenant | Lt | Sub Lt/Surg Sub Lt | S Lt /Surg S Lt | Flying Officer | Fg Offr | – | – |
PBOR
ARMY | Abbreviation | NAVY | Abbreviation | AIR FORCE | Abbreviation | Indian Coast Guard | Abbreviati on |
Honorary Captain | Hony Capt | Honorary Lieutenant | Hony Lt (IN) | Honorary Flight Lieutenant | Hony Flt Lt | – | – |
Honorary Lieutenant | Hony Lt | Honorary Sub Lieutenant |
Hony Sub Lt (IN) | Honorary Flying Officer | Hony Fg Offr | – | – |
Subedar Major or Risaldar Major | Sub Maj or Ris Maj | Master Chief Petty Officer1 | MCPO 1 | Master Warrant Officer | MWO | Pradhan Adhikari or Pradhan Sahayak Engineer | P/Adh or PSE |
Hony Sub Maj or Hony Ris Maj | Hony Sub Maj or Hony Ris Maj | Honorary Master Chief Petty Officer1 | Hony MCPO1 | Honorary Master Warrant Officer | Hony MWO | – | – |
Subedar or Risaldar | Sub or Ris | Master Chief Petty Officer 2 | MCPO 2 | Warrant Officer | WO | Uttam Adhikari, or Uttam Sahayak Engineer | U/Adh or USE |
Hony Subedar or Hony Risaldar | Hony Sub or Hony Ris | – | – | – | – | – | – |
Naib Subedar or Naib Risaldar | Nb Sub or Nb Ris | Chief Petty Officer | CPO | Junior Warrant Officer/Flight Sergeant | JWO/Flt Sgt | Adhikari, or Sahayak Engineer or Pradhan Yantrik | Adh or SE or P/Ytk |
Hony Naib Sub or Hony Naib Risaldar | Hony Nb Sub or Hony Nb Ris | – | – | – | – | – | – |
Havildar or Dafedar | Hav or Dfr | Petty Officer | PO | Sergeant | Sgt | Pradhan Navik or Uttam Yantrik or Yantrik | P/Nvk or U/Ytk or Ytk |
Honorary Havildar or Hony Dafedar | Hony Hav or Hony Dfr | – | – | – | – | – | – |
Naik or Lance Dafedar | Nk or LD | Leading | Ldg | Corporal | Cpl | Uttam Navik | U/Nvk |
Lance Naik or Asst Lance Dafedar | LNK or ALD | Seaman I | Sea I | Leading Air Craftsman | LAC | Navik or Enrolled Follower | Nvk or E/F |
Sepoy (Rfn, Gdsm, Swr, Spr, Sigmn,Cfn, Gnr | Sep | Seaman II | Sea II | Air Craftsman | AC | ||
Recruit | Rect | Recruit | Rect | Recruit | Rect | – | – |
Source: http://echs.gov.in/images/pdf/stats/stats2.pdf
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