Claim Bhamashah Pashu Bima Yojna
Applicant Information
Aadhaar (UID or EID Number)
Bhamashah ID
1. Title
2. Name of Owner
3. Father Name / Husband
4. Gender
Male
Female
Other
5. Caste Category
6. Mobile Number
7. BPL Card Number
Current Address
1. Address In English
2. Address in Hindi
3. Country
4. State
5. Division
6. District
7. Tehsil
8. Municipality
9. Ward
10. Panchayat Samity
11. Gram Panchayat
12. Village
13. Pin Code
Veterinarian who issued PM Report
1. Posting Place
2. Name of Insurance Company
3. Name of the Certifying Doctor
4. Status of Claim
5. Date of Claim Amount Paid to Cattle Owner
6. Amount of Claim Paid to Cattle Owner
7. IF REJECTED, REASON OF REJECTION
Bank Detail
1. IFSC Code
2. Name of Bank
3. Name of Bank Branch
4. Account Number
Declaration:
The information provided by me is true to the best of my knowledge.
Signature of Applicant
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