AFOVA Newletters of Year 2001

Page 44 of 52 to-day medical expenditure that do not require hospitalisation. The pensioners are required to exercise a one-time option to either avail the medical facilities at the OPDs of the AF hospitals or to claim the fixed Medical Allowance. Specimen Forms and letters are given below for your perusal and action. &&&&&&&&&&&&& SPECIMEN - FORM OF OPTION- (in 4 Copies please) 1(i) I, No ……………. Rank …………….. Name ………………… hereby opt to avail the Medical facilities under the Armed Forces Medical Scheme. OR (ii) I, No ………………… Rank …………….. Name ………………… hereby opt to claim the Fixed amount of Rs 100/- per month in lieu of making use of the OPD facilities in AF Hospitals. Signature ……… Name: Date: Personal Number Station: Chennai Unit/Formation Counter signed (Commissioned Officer/Treasury/PSB/Paying Branch/DPDO/PAO) with seal ******************************** SPECIMEN - FORM TO BE FURNISHED BY THE PENSIONER TO THE PDA - (4 COPIES) I, No ………….. Rank ………….. Name ……………. Hereby declare and undertake that I am entitled top medical facilities under Armed Forces Medical Scheme. My residential address is: …………………………. …………………………. …………………………. PPO number ………………. Account No, and Name and address of the Bank: PDA: Signature ……… Name: Date. Personal Number Station: Chennai Unit/Formation Counter signed (Commissioned Officer/Treasury/PSB/Paying Branch/DPDO/PAO) with seal **************************