Kindly prepair our file in this order as soon as possible.
Documents in Sr. order
- Letter form ESI (to be made by ESI Disp.)
- Request Leter form IP to ESI
- e-Pehchan Card
- Entitled to benefit sheet.
- History sheet of the patient (ESI signature)*
- OPD slip of ESI Hospital
- History sheet of patient (from specialty hospital)
- Letter head of specialty hospital
- OPD slip of speciality hospital
- ESI R.C. (2 pages)
- Aadhar card issued person
- Aadhaar card of patient
- Consumption certificate
- ESI board form
- Copy of Privious OPD slip of Specialty Hospital (on which privious medicine was recived) - Part of ESI Board Form.
- Any other if required
Formats (Kindly edit formats on PC / Laptop) mobile may not support.
*
👉 Kindly update RC Referance on - History sheet of the patient (ESI signature)
Updated lines -
Require medicine available to ESIC RC No./item No./ Item No.:-2209/2210 RC.NO.-U-25/12/RC/159TO163/2022-Med. V(E-117064)/159,160 dated-08.04.2025, with ADDENDUM dated 02/07/2025. It is to certify that this medicine is available on the Rate Contract of ESIC RC No.159 & 160. Further, this medicine is not in the stock of ESI Dispensary/Hospital.
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