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  • MRS Op Option Form

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    Silamparasu Bsnl
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    This document is a form for retired Bharat Sanchar Nigam Limited (BSNL) employees to select their Medical Reimbursement Scheme (MRS) option. The form requests information such as the retiree's name, HR number, designation at retirement, retirement date, last posting office, existing MRS card number, last month's salary details, PPO number, option selected for CGHS or OPD claim reimbursement, address, contact details, bank account information, and signature. Retirees must attach a copy of their existing MRS card with the completed form.

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    MRS op option form

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    This document is a form for retired Bharat Sanchar Nigam Limited (BSNL) employees to select their Medical Reimbursement Scheme (MRS) option. The form requests information such as the retiree's name, HR number, designation at retirement, retirement date, last posting office, existing MRS card number, last month's salary details, PPO number, option selected for CGHS or OPD claim reimbursement, address, contact details, bank account information, and signature. Retirees must attach a copy of their existing MRS card with the completed form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
    64 views1 page

    MRS Op Option Form

    Uploaded by

    Silamparasu Bsnl
    This document is a form for retired Bharat Sanchar Nigam Limited (BSNL) employees to select their Medical Reimbursement Scheme (MRS) option. The form requests information such as the retiree's name, HR number, designation at retirement, retirement date, last posting office, existing MRS card number, last month's salary details, PPO number, option selected for CGHS or OPD claim reimbursement, address, contact details, bank account information, and signature. Retirees must attach a copy of their existing MRS card with the completed form.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Flag for inappropriate content
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    ¦ÉÉ®úiÉ ºÉÆSÉÉ®ú ÊxÉMÉ¨É Ê±ÉʨÉ]äõb÷ BHARAT SANCHAR NIGAM LIMITED

    (¦ÉÉ®úiÉ ºÉ®úEòÉ®ú EòÉ =t¨É A Govt. of India Enterprise)

    सेवा निवत्त
    ृ कर्मचारियों के लिए बीएसएिएि एर्आिएस ववकल्प फार्म
    BSNL MRS OPTION FORM FOR RETIRED EMPLOYEES
    (BSNL CO No .BSNL/Admn/15-12/18 dtd 08.05.2020)

    1
    Name
    2 HR No
    3 Designation on date of retirement/VRS
    4 Date of retirement/VRS
    5 Name of Office and SSA of last posting
    6 Existing MRS Card no
    7 Last Month’s Salary

    (1) Basic
    (2) DA
    8 PPO No
    9 Option CGHS OP claim with voucher without voucher
    (tick one) 15 days pay (basic+ DA on Rs 1000/- (one thousand)
    date of retirement) per month

    10 Address after retirement

    11 Contact no Mobile
    Landline
    12 Name of the Bank, Branch & A/c No, IFSC code

    सेवा निवत्त
    ृ कर्मचारी का हस्ताक्षर
    Signature of the retiree
    Note: Please attach copy of MRS card

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