AIGETOA CTD
Group Health Insurance for all BSNL Executives through National Insurance Company
Email *
GHI Coverage required
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1. Please read the premium & charges  document very carefully before proceeding further.
2. Filled Up data shall be used to calculate final amount to be paid after discount as applicable.
3. Data filled in this form will be used for final payment and it will be intimated in due course of time.
4. No deletion / alteration is possible at any point of time. Be very careful while filling up data.
5. Please do not make duplicate entry. Duplicate entry may leads to removal of data.
6. This form is designed to collect baseline data and does not guarantee issuance of health policy which is subject to final agreement and payment with the insurer.
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BSNL Executive Per No (8 Digit)
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BSNL Executive Name
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BSNL Executive Gender
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Employee Mobile Number
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Employee Email Address
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Employee Aadhaar Number
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Employee PAN Number
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Employee Date Of Birth
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