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    THDC India Limited: From D' Life Certificate

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    THDC OFFICERS CLUB
    This document is a life certificate issued by THDC India Limited certifying that a retired employee and their spouse are alive. It provides their names and address and states that the certificate is being issued to allow for the release of payment for outdoor or domiciliary medical treatment under THDCIL's post-retirement medical benefits scheme. The signatures or thumb impressions of the retired employee and spouse are attested by a registered medical practitioner, gazetted officer, or bank manager. It is noted that the spouse's signature is mandatory for couple memberships and a separate declaration is required if claiming for dependent children.

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    THDC India Limited: From D' Life Certificate

    Uploaded by

    THDC OFFICERS CLUB
    334 views1 page
    This document is a life certificate issued by THDC India Limited certifying that a retired employee and their spouse are alive. It provides their names and address and states that the certificate is being issued to allow for the release of payment for outdoor or domiciliary medical treatment under THDCIL's post-retirement medical benefits scheme. The signatures or thumb impressions of the retired employee and spouse are attested by a registered medical practitioner, gazetted officer, or bank manager. It is noted that the spouse's signature is mandatory for couple memberships and a separate declaration is required if claiming for dependent children.

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    This document is a life certificate issued by THDC India Limited certifying that a retired employee and their spouse are alive. It provides their names and address and states that the certificate is being issued to allow for the release of payment for outdoor or domiciliary medical treatment under THDCIL's post-retirement medical benefits scheme. The signatures or thumb impressions of the retired employee and spouse are attested by a registered medical practitioner, gazetted officer, or bank manager. It is noted that the spouse's signature is mandatory for couple memberships and a separate declaration is required if claiming for dependent children.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    334 views1 page

    THDC India Limited: From D' Life Certificate

    Uploaded by

    THDC OFFICERS CLUB
    This document is a life certificate issued by THDC India Limited certifying that a retired employee and their spouse are alive. It provides their names and address and states that the certificate is being issued to allow for the release of payment for outdoor or domiciliary medical treatment under THDCIL's post-retirement medical benefits scheme. The signatures or thumb impressions of the retired employee and spouse are attested by a registered medical practitioner, gazetted officer, or bank manager. It is noted that the spouse's signature is mandatory for couple memberships and a separate declaration is required if claiming for dependent children.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    THDC INDIA LIMITED

    From ‘D’

    LIFE CERTIFICATE

    This is to certify that Shri./Smt____________________________S/O, D/O


    Shri._______________________________________________________ and
    Shri./Smt.________________________wife/husband of
    Sh./Smt.__________________________________residing at _________
    _____________________________ are known to me and is/are alive at the time of
    issuing this certificate. The certificate is issued for release of payment for outdoor/
    domiciliary treatment under THDCIL Contributory Scheme for Post Retirement Medical
    Facilities.

    The signatures/thumb impression of the above mentioned persons is/are attested


    hereunder.

    Signature of Retired employee:

    Signature of Spouse:

    __________________________________________
    Signature of Registered Medical Practitioner with regd. No.
    OR Gazetted Officer at Central/State Govt. OR The Branch
    Manager of the Bank where the retired Executive/Spouse is
    holding Saving Bank Account or Any Officer of the Company
    from where the Medical Facility is obtained.

    With Seal/Stamp/ Emp No./Designation in case of THDCIL


    Officer

    Date:

    Registration Number of Medical Card:

    Note:Signature/ Thumb impression of spouse is mandatory in case couple


    membership. In case claim is also being made for dependent children a separate
    declaration about his/her eligibility and being alive shall be submitted by ex-
    employee.
    Declaration: The facts mentioned above are true to my best of knowledge and in
    case of false or wrong information, the benefit under the scheme shall be forfeifited
    and I/we shall no claim whatsoever.

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