Option form for Social Security Schemes for Executives in BSNL, Punjab Telecom Circle
1.Name: *
Your answer
2.Fathers Name: *
Your answer
3.Mobile No: *
Your answer
4.Date of Birth: *
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DD
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YYYY
5.Date of Retirement: *
MM
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DD
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YYYY
6.HRMS NO: *
Your answer
7.E-mail address *
Your answer
8.Name of Association: *
Your answer
9.Name of SSA: *
Your answer
10.Designation: *
11.Whether you are interested in Group term Insurance Purely funded by Executives in BSNL Punjab Circle *
12.Whether you are interested Benevolent Fund entirely funded by Executives in BSNL Punjab Circle *
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