This application is applied for financial assistance in case of minor ailments.
Documents to be submitted with application:
1. Proof of Identity/Smart card issued by the Board
2. Employment Certificate
3. Proof of Bank Account
4. Bills of hospital showing Admission and Discharge Dates and all treatment given
5. Any medical documents on hospitalization of beneficiary/dependent in government/private hospital included in schedule1 of the Karnataka government servents(medical attendance) Rules 1963.
6. Form XXII-A
7. Application can be submitted wihtin 6 months of hospitalisation commencement date.