This document outlines the fields and required documents for an employee and their family members to submit an application for medical insurance through the UMID program. It lists the registration fields for the employee including their PF/employment number, PAN number, date of birth, and application fields for family members such as name, date of birth, relationship to employee, and contact details. It also provides a checklist of common documents required for all applicants like photographs and ID proofs as well as relationship-specific documents needed for different family members like birth certificates, marriage certificates, and bona fide certificates for students over age 21.
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UMID For Employee
This document outlines the fields and required documents for an employee and their family members to submit an application for medical insurance through the UMID program. It lists the registration fields for the employee including their PF/employment number, PAN number, date of birth, and application fields for family members such as name, date of birth, relationship to employee, and contact details. It also provides a checklist of common documents required for all applicants like photographs and ID proofs as well as relationship-specific documents needed for different family members like birth certificates, marriage certificates, and bona fide certificates for students over age 21.
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Application Form Fields for Employee & Family Members
Employee Registration Fields Checklist of Documents for Submission of UMID Application
PF/Empl Number (11 digits) As a ready reckoner the following is the check-list for mandatory fields and documents to be scanned in PAN Number JPEG/JPG format for advanced preparedness to initiate the application in a full-fledged manner: Date of Birth Common Documents for All: Photograph of Employee & all the dependants Signature of employee Employee Application Old Medical ID card of employee Field Names ID proof of all individual dependants. Gender Blood Group Relation with Marital Documents required Aadhaar No* employee Status Residential Address* Mother Widow Father death certificate Health Unit Opted* Step mother Widow Father death certificate City* Son Unmarried If student above 21 yrs, Bonafide Certificate Pincode* Daughter Divorced Divorce Decree Email ID Daughter Widow Marriage Certificate & Death certificate of her husband Step son Unmarried If student above 21 yrs, Bonafide Certificate Step Daughter Divorced Divorce Decree Family Members’ Application Step Daughter Widow Marriage certificate & Death Certificate of her husband Field Names Brother Unmarried Father Death Certificate and If student above 21 yrs, Bonafide Family Member Name* Certificate Date of Birth Step - brother Unmarried Father Death Certificate and If student above 21 yrs, Bonafide Relation* Certificate Marital Status* Sister Unmarried Father Death Certificate Phy./Men. Challenged* Sister Divorced Father Death Certificate and Divorce Decree Blood Group Sister Widow Father Death Certificate, Marriage Certificate & Death certificate of her Residential Address* husband City* Step-sister Unmarried Father Death Certificate Pincode Step-sister Divorced Father Death Certificate and Divorce Degree Health Unit Opted Step-sister Widow Father Death Certificate, Marriage Certificate & Death certificate of her Aadhaar No husband PAN # In case of Physically/Mentally challenged dependents – Railway Doctor Certified Medical Email ID Certificate to be uploaded. Mobile No. * Note: The (*) Marked Fields are the Mandatory Fields in the Application Form.