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Form analysis
1 forms found in the DOM

Name: download —

<form name="download" autocomplete="off" class="ng-pristine ng-valid">
  <div>
    <div id="wrapper">
      <div class="clearfix"></div>
      <div class="container mind_content">
        <!--Start breadcrumb-->
        <div class="">
          <ol class="breadcrumb">
            <li><a href="#!/home" ui-sref="footer.home" class="ng-binding">Home</a></li>
            <!--<li><a href="" ui-sref="footer.home">Home</a></li>-->
            <li class="active">Claimform</li>
          </ol>
        </div>
        <div class="clearfix"></div>
        <!--end breadcrumb-->
        <div class="containbox mt20">
          <h3>
            <font face="Century Gothic, Arial"><span>Download</span></font>
          </h3>
          <div class="wrapper_boxes">
            <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
              <div class="col-lg-4 col-md-4 col-sm-12 col-xs-12">
                <img class="img-responsive" src="enrollment/images/cashlesh.png">
                <a href="enrollment/DownloadPDF/Cashless_Request_Form.pdf" target="_blank"><p class="mt8">  Cashless Request Form</p></a>
              </div>
              <div class="col-lg-4 col-md-4 col-sm-12 col-xs-12">
                <img class="img-responsive" src="enrollment/images/claim_partA.png">
                <a href="enrollment/DownloadPDF/Claim_Form_partA.pdf" target="_blank"><p class="mt8">  Claims Form Part A</p></a>
              </div>
              <div class="col-lg-4 col-md-4 col-sm-12 col-xs-12">
                <img class="img-responsive" src="enrollment/images/sample_claim_forms.png">
                <a href="enrollment/DownloadPDF/Claim_Form_partB.pdf" target="_blank"><p class="mt8">  Claims Form Part B</p></a>
              </div>
            </div>
            <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
              <div class="col-lg-4 col-md-4 col-sm-12 col-xs-12">
                <img class="img-responsive" src="enrollment/images/hospital_information_sheet.png">
                <a href="enrollment/DownloadPDF/Hospital Information Sheet.pdf" target="_blank"><p class="mt8">  Hospital Information Sheet</p></a>
              </div>
              <div class="col-lg-4 col-md-4 col-sm-12 col-xs-12">
                <img class="img-responsive" src="enrollment/images/claim_partB.png">
                <a href="enrollment/DownloadPDF/Claim_submission_check_list.pdf" target="_blank"><p class="mt8">  Claim Submission Checklist</p></a>
              </div>
              <div class="col-lg-4 col-md-4 col-sm-12 col-xs-12">
                <img class="img-responsive" src="enrollment/images/IRDA_guidelines.png">
                <a href="enrollment/DownloadPDF/IRDA-guidelines.pdf" target="_blank"><p class="mt8">  IRDA Guidelines</p></a>
              </div>
            </div>
            <div class="col-lg-12 col-md-12 col-sm-12 col-xs-12">
              <div class="col-lg-4 col-md-4 col-sm-12 col-xs-12">
                <img class="img-responsive" src="enrollment/images/claim_partB.png">
                <a href="enrollment/DownloadPDF/Sample Claim_Form_partA.pdf" target="_blank"> <p class="mt8">   Sample Claim Form Part A </p></a>
                <a href="enrollment/DownloadPDF/Sample Claim_Form_partB.pdf" target="_blank"> <p class="mt8">  Sample Claim Form Part B </p></a>
              </div>
              <div class="col-lg-4 col-md-4 col-sm-12 col-xs-12">
                <img class="img-responsive" src="enrollment/images/PPN_network.jpg">
                <a href="enrollment/DownloadPDF/PPN_Declaration_Form.pdf" target="_blank"><p class="mt8">PPN Networks Declaration Form</p></a>
              </div>
              <div class="col-lg-4 col-md-4 col-sm-12 col-xs-12">
                <img class="img-responsive" src="enrollment/images/calculator_right.jpg">
                <a href="enrollment/DownloadPDF/First_Consultation_Letter_Format.pdf" target="_blank"><p class="mt8">First Consultation Letter Format</p></a>
              </div>
            </div>
            <div class="clearfix"></div>
          </div>
        </div>
      </div>
    </div>
  </div>
</form>

Text Content

 1. Home
    
 2. Claimform




DOWNLOAD

Cashless Request Form

Claims Form Part A

Claims Form Part B

Hospital Information Sheet

Claim Submission Checklist

IRDA Guidelines

Sample Claim Form Part A

Sample Claim Form Part B

PPN Networks Declaration Form

First Consultation Letter Format




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reserved.