Form - B (West Bengal Police Medical Insurance Policy for the year 2021-2022)
(Maximum 6 persons are allowed on 1 (Self) + 1 (Spouse) + 2 [Son (s) / Daughter (s)/ Brother (s)/ Sister (s)] + 2 (Either parents or In-laws).
Policy Premium - Rs. 10,500/- (Rs. 6,000/- to be paid by the Corporation and Rs. 4,500/- to be deducted from the salary of November, 2021 of the employee)
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Name of the Employee
Rank / Designation
Previous Year Genins Card ID, if any (2020- 2021)
Date of Birth
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