CGHS Medical Claim Form-Check List

CGHS(Central government health scheme) regurarlry update the medical facility provided by the government of india to government employee and its retired employee. Currently, it provide facility to 40 lakh enrolled memmber in 75 cities. And to avail the medical reimbursement you need to file a medical claim with the details about the patient , his/her medical condition, alaong with the total bill.

You could also book the online consulation by login into CGHS . There is option to download a CGHS card and avail the medical benefits to the eligible individuals.

You will need a medical claim form to provide all these details, in this post you will get the download option in the pdf format

Once downloaded, fill the from and submit it to the nearest CGHS office.


What Document and information you need to fill in the medical claim form of CGHS

  • CGHS Token number and place of issue
  • Validity date of CGHS card
  • Full name on the card.
  • Status(Government servant /pensioner/ Other)
  • Document
    • Medical 2004 form
    • Photocopy of CGHS Card
    • Essentiality certificate
    • No. of original bills
    • Whether original bills/vouchers have been verified.
    • Copy of discharge summary
    • Copy of permission letter
    • etc.

Medical Claim Form of CGHS [Download PDF]

Here is the pdf format of CGHS medial claim form, click on the below link to downlaod.

CGHS provides health care through following systems of Medicine

  • Allopathic
  • Homoeopathic
  • Indian system of medicine
    • Ayurveda
    • Unani
    • Siddha and
    • Yoga

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