Appendix 'A' (Refer to Para 7(a) of letter No B/49774 ... - Indian Army
Appendix 'A' (Refer to Para 7(a) of letter No B/49774 ... - Indian Army Appendix 'A' (Refer to Para 7(a) of letter No B/49774 ... - Indian Army
1. Janglot 2. Moga 3. Sangrur 4. Sirsa 5. Jaisalmer 6. Ajmer 7. Saharanpur (Sarsawa) 8. Bharatpur 9. Balasore 10. Nagpur 11. Yelahanka 12. Dimapur 13. Shajahanpur 14. Kotdwara 15. Haldwani 16. Mumbai (Upnagar) Powai Appendix ‘E’ (Refer to Para 10 of letter No B/49774/AG/ECHS/Referral dt ____ Dec 2009) 15
EX-SERVICEMEN CONTRIBUTORY HEALTH SCHEME ECHS POLYCLINIC …………………(Station) REFERRAL FORM Part I OPD Regn No ……………………………… date …………………… ECHS Card No …………………………….. Name of patient ………………………… Age ……. Relationship with ESM …………. Service No ………………….. Rank ………….. Name of ESM …………………………. Tele No ………………………………….. Brief Clinical Notes Provisional Diagnosis
- Page 1 and 2: Appendix ‘A’ (Refer to Para 7(a
- Page 3 and 4: Appendix ‘C’ Imaging (Refer to
- Page 5: Other (Specify) CT Scan Orthodontia
- Page 9 and 10: SUMMARY OF THE CASE (To be complete
- Page 11 and 12: Specialists Medical Dental E ECHS R
- Page 13 and 14: in Station Appendix ‘G’ (Refer
- Page 16 and 17: Tele: 25684945 Central Organisation
- Page 18 and 19: (a) Inconvenience and hardships to
- Page 20 and 21: 10. The policy shall be reviewed af
- Page 22 and 23: 4. In case the concerned specialist
- Page 24 and 25: ‘L’ Block, New Delhi - 110 001
- Page 26 and 27: Integrated HQ of MOD (Army) Maude L
- Page 28 and 29: Kendirya Sainik Board - For info. I
- Page 30 and 31: REVISED CHANNEL OF PROCESSING OF IN
- Page 32 and 33: SUB HEAD - F, CODE HEAD - 365/00 1.
- Page 34 and 35: (a) GOI, MOD letter No 24(8)/03/US(
- Page 36 and 37: Copy to :- ________________________
- Page 38 and 39: 3. The following are the guidelines
- Page 40 and 41: HQs WNC, SNC & ENC HQs WAC, CAC, EA
- Page 42 and 43: Sd/-x-x-x-x (RK Kalra) Maj Gen MD E
- Page 44: (i) Himachal Pradesh. (ii) Uttranch
1. Janglot<br />
2. Moga<br />
3. Sangrur<br />
4. Sirsa<br />
5. Jaisalmer<br />
6. Ajmer<br />
7. Saharanpur (Sarsawa)<br />
8. Bharatpur<br />
9. Balasore<br />
10. Nagpur<br />
11. Yelahanka<br />
12. Dimapur<br />
13. Shajahanpur<br />
14. Kotdwara<br />
15. Haldwani<br />
16. Mumbai (Upnagar) Powai<br />
<strong>Appendix</strong> ‘E’<br />
(<strong>Refer</strong> <strong>to</strong> <strong>Para</strong> 10 <strong>of</strong> <strong>letter</strong> <strong>No</strong><br />
B/<strong>49774</strong>/AG/ECHS/<strong>Refer</strong>ral<br />
dt ____ Dec 2009)<br />
15
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