Rehabilitation Form

STAFF WELFARE ORGANIZATION

Ch. Rehmat Ali Community Centre,

G-7, ISLAMABAD.

(Ph.2892135, 9253000)

 

APPLICATION FORM FOR GRANT OF REHABILITATION AID TO FEDERAL

GOVERNMENT EMPLOYEES AND THEIR DEPENDANTS.

 

1.         Name & Designation. ________________________________________________

            __________________________________________________________________                       

2.         Ministry/ Deptt. where employed  ______________________________________

            __________________________________________________________________

                                   

3.         Name of the dependent          __________________________________________

            patient.                                                           

 

4.         Relationship of the patient     

            with the Federal Government

            Employee.                                        Wife, Son, Daughter, Father, Mother, Self          

 

  5.         Rehabilitation aid required.____________________________________________

                                                                               

 6.         Details of rehabilitation

            aid last provided by the                                a)         Cash ___________________

            S.W.O.

                                                                                    b)         Kind ___________________

7.         Phone/Cell No. ________________________         

 

 

 

 

Signature of the Federal

Government Servant.

 

       RECOMMENDATION OF THE DEPARTMENT.

 

F. No.________________                                                             Dated________________

 

                        It is certify that Mr./Miss/Mrs.________________________ designation __________________ is working in this Ministry/Division/Deptt, his date of retirement is __________________.

 

 

Seal and Signature of the

Head of Department or his

authorised officer.

Terms/conditions overleaf

 

:-2-:

TERMS/CONDITIONS

                        The following documents duly attested must be attached with the application form.

1.              Copy of Payslip, issued by A.G.P.R.

2.              Copy of CNIC of employee and dependent.

3.              Copy of Form “B” (in case of claim for their children).

4.              Medical Certificate issued by authorized Medical Attendant .

5.              Any other documents as desired by the Staff Welfare Organization time to time.

6.              Employees working in “Autonomous/Semi Autonomous bodies” are not entitled.

 

7.              Retired employees are not eligible.

8.             Only serving Federal Government Employees who are drawing their salaries from A.G.P.R., are eligible.

 

9.             In case of dependent, only Mother/Father, Wife and Unmarried Children are eligible.

 

10.         In case of any interpretation / clarification of above terms / condition, the  decision of the Federal Medical Board shall  be final

 

 

 

 

 
 

 



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Address: Staff Welfare Organization G-6, Aabpara, I   slamabad.

Phone: +92-51-9244564
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