Checklist:

• Minutes of the meeting / Check List of the District Level Admissibility Board (seal & signature of the Members alongwith Admissible amount by name of incumbent concerned is mandatory to furnish along with the Admissibility Report)
• Admissibility Report from the Jt. Director of Health Services (concerned district).
• Authorized Medical Attendants recommendation (if applicable).
• Referral Medical Board’s Certificate
• Essentiality Certificate.
• Discharge Summary/Certificate.
• Records of Hospital.
• Certificate from the Hospital authority.
• Final bill / Bill summary issued by the Hospital authority.
• Attested copy of Bank Pass Book.
• Attested copy of G.P.F./C.P.F. Statement.
• Attested copy of Pension Payment Order.
• Death Certificate (if applicable).
• Birth Certificate (if applicable).
• Legal Heir Certificate (if applicable).
• Original bills/vouchers etc.
• Leave order for the treatment period (if applicable).
• A self declaration / undertaking of no claim from other sources.
• Dependant certificate from concerned authority (if applicable).
• Physical Verification Certificate of concerned D.D.O.