AFVOA Newletters of Year 2010

Page 44 of 50 Sep 2010. APPLICATION FORM FOR UPGRADATION OF ECHS SMART CARD FOR EXISTING MEMBERS (CARD HOLDERS) (FILL UP ALL DETAILS IN BOLD LETTERS) 1. Pensioner/Family Pensioner Name:_________________ 2. Relationship: Self/Spouse/Father/ Mother/Son/Daughter Of 3. Service No______________ Rank___________ Name_______________ 4. Existing Card Regn No ____________________ 5. Force: Army/Navy/Air Force/Coast Guard/DSC/SFF (As applicable) 6. Details of member/ dependents:- Ser No Member/ Dependent Name (with address and tele No with STD code if deferent from existing one) Relationship Parent Polyclinic required Latest Colour Photo(Passport Size) with white background UIDNo (if available) UIDNo (if available) UIDNo (if available) UID No (if available) 8. Total cards demanded 9. Amount (Rupees) 10. Payment Details: DD No