Form - C (West Bengal Police Medical Insurance Policy for the year 2021-2022)
(Maximum 2 persons are allowed on 1 (Self) + 1 (Spouse).
Policy Premium - Rs. 10,000/- (Rs. 6,000/- to be paid by the Corporation only in case of consolidated remuneration otherwise whole amount will be deducted from the salary of November, 2021 of the employee)
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Email *
Name of the Employee *
Rank / Designation *
Previous Year Genins Card ID, if any (2020- 2021)
PPO No.
Pension Sanctioning Authority
Date of Birth *
MM
/
DD
/
YYYY
Gender *
Mobile No. *
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