Revised NB Forms for LIC with form number

FORM NO.

REVISED NB FORMS / DESCRIPTION

3166

POLICY EXTRACT FROM PREVIOUS /PROPOSAL PAPERS

3179® 2K

CONSENT LETTER

3302

MEDICAL EXAMINER'S APPLICATION

NB-44

BM's RECOMMENDATATION FOR APPOINTMENT OF MEDICAL EXAMINER

3302A

APPOINTMENT OF CARDIOLOGIST/ RADIOLOGIST/PATHOLOGIST

4104A

STATEMENT WHERE NO STD AGE PROOF

RE-CHECK

RE-CHECK OF MEASUREMENTS

P-FIN.QUEST.

PERSONAL FINANCIAL QUESTIONNAIRE

AGRL.INC.

CERTIFICATE OF AGRICULTURAL INCOME

CA CERT.

CHARTERED ACCOUNTANT'S CERTIFICATE

FEMALE-III

SPECIAL MHR FOR WIDOWS

P' SHIP

SUPPLEMENTARY DEED OF PARTNERSHIP

FORM 14

EPF - APPLICATION

FORM 15

EPF ASSIGNMENT FORM

294

ADDENDUM TO MINOR LIVES PROPOSALS

400

ADDENDUM FORM FOR JEEVAN SATHI T - 89

ADDNDM

ADDENDUM TO (PPL) JEEVAN BHARATI T-160

ADDNDM

ADDENDUM TO (PPL) JEEVAN ADHAR T-114

ADDNDM

ADDENDUM TO CAESARIAN CASES

FEMALE-I

ADDENDUM TO PPL-CAT-I FEMALE LIFE

HUF

ADDENDUM - HUF POLICIES

3261

ELDER’S DECLARATION OF AGE

5096

SELF DECLARATION OF AGE (UNSTAMPED)

5220

SELF DECLARATION (STAMPED) UNDER (C) DECLARATIONS

DECLN

DECLARATION (PPL) JEEVAN VISWAS T-136

DECLN

DECLARATION (PPL) JEEVAN KISHORE / KOMAL JEEVAN T-102,159

DECLN

DECLARATION (PPL) - JEEVAN CHAYA T-103

3322

ADDITIONAL FORM FOR ASTHMA/BRONCHITIS

3324

ULCER QUESTIONNAIRE- WITH OPERATION

3325

ULCER QUESTIONNAIRE - WITHOUT OPERATION

3326

KIDNEY DISEASE, COLIC OR STONE ETC

3327

GALL-BLADDER DISEASE

3330

GOITRE QUESTIONNAIRE (WITH OPERATION)

3331

GOITRE QUESTIONNAIRE (W/O OPERATION)

3332

FILARIASIS QUESTIONNAIRE

3333

CHEST PAIN QUESTIONNAIRE

3334

CNS QUESTIONNAIRE

3336

TUBERCULOSIS QUESTIONNAIRE

3337

PLEURISY QUESTIONNAIRE

3340

EPILEPSY QUESTIONNAIRE

DEFORMITY

DEFORMITY QUESTIONNAIRE

HERNIA

HERNIA QUESTIONNAIRE

HEARING/ENT

HEARING/ENT QUESTIONNAIRE

LIC03-500

GENERAL OCCUPATION QUESTIONNAIRE

LIC03-500-01

ARMY PERSONNEL QUESTIONNAIRE

LIC03-500-02

AVIATION (ARMED SERVICES) QUESTIONNAIRE

LIC03-500-03

AVIATION (CIVIL) QUESTIONNAIRE

LIC03-500-04

CIVIL GLIDING QUESTIONNAIRE

LIC03-500-05

NAVY PERSONNEL QUESTIONNAIRE

LIC03-500-06

DIVING (ARMED/COMML) QUESTIONNAIRE

LIC03-500-07

MERCHANT MARINE QUESTIONNAIRE

EMPL-EMP

EMPLOYER-EMPLOYEE QUESTIONNAIRE

KEYMAN

ANX-A-KEYMAN( RESOLUTION)

KEYMAN

ANX-B - KEYMAN QUESTIONNAIRE

KEYMAN

ANX-C - KEYMAN(INC-INS)

NR1-1

MAIL ORDER BUSINESS - ACR / MHR

NRI-2

NRI - ANX - STUDENTS/ EMPLOYEES

NRI-3

NRI - QUESTIONNAIRE

NRI-4

NRI - CONDITIONS

3310

FLUOROSCOPIC EXAMINATION

3311(a)

GLUCOSE TOLERENCE TEST (GTT) OF URINE

3313

X-RAY OF GENITO URINARY TRACT (G U T) KUB AREA

3314

STOMACH & DUODENUM (BARIUM MEAL)

3315

X-RAY - CAECUM AND COLON (BARIUM ENEMA)

3316

INTRAVENOUS PYELOGRAPHY

3317

CHOLECYSTOGRAPHY

3321

SPUTUM EXAMINATION

3335

STOOL EXAMINATION

3338®

SPECIAL BLOOD SUGAR TEST (BST)

3341

GYNAECOLOGIST REPORT

LIC03-002

ELECTROCARDIOGRAM

LIC03-003

TREADMILL TEST

LIC03-004

HAEMOGRAM

LIC03-005

LIPIDOGRAM

LIC03-006

BLOOD SUGAR TEST (BST)

LIC03-007

SPECIAL BIO-CHEMICAL TESTS (SBT-12)

LIC03-008

SPECIAL BIO-CHEMICAL TESTS (SBT-18)

LIC03-009

ROUTINE URINE ANALYSIS (RUA)

LIC03-010

CHEST X-RAY

LIC03-011

ELISA FOR HIV

LIC03-012

PHYSICIAN’S REPORT

OPHTHALMIC

OPHTHALMIC REPORT

JUVENILE

JUVENILE FMR

3124B

CLAUSE 4(B)

3130A

CLAUSE 10(a)

3140

CLAUSE 20 - WAIVER OF PREMIUM CLAUSE

3140A

CLAUSE 20A - WAIVER OF PREMIUM CLAUSE - PLAN 113 ETC

3140B

CLAUSE 20B - FAMILY BENEFIT CLAUSE - PLAN 113 ETC

SSS

SSS INTRODUCTION - ANNEXURE I(A)

3142

CLAUSE-22 - ANNEXURE II (A)

3151

CLAUSE 31

3152

CLAUSE 32

CLAUSES

CL 45, 46, 53, 54, 55, 56

3198

CLAUSE 61(SPL DISABILITY CL.)

3198(N)

CLAUSE 61(N)

3198(I)(N)

CLAUSE 61(I) (N)

3198(a)

CLAUSE 61(a)

3198 AI N

CLAUSE 61(a)(I)(N)(WITH AB)

3198(a)(N)

CLAUSE 61(a)(N)(W/O AB)

3214

CLAUSE 65

3215

CLAUSE 66

3216

CLAUSE 67

3218

CLAUSE 69

3228

CLAUSE 74

3230

CLAUSE 76

CLAUSE

CLAUSE 85

CLAUSE

CLAUSE 86

FORM-A

SSS INTRODUCTION - EMPLOYER'S LETTER

FORM-B

SSS INTRODUCTION - QUESTIONNAIRE BY EMPLOYER

FORM-C

SSS INTRODUCTION - REPORT BY SBM/ABM(S)

460(R-87) PERSONAL

STATEMENT REGARDING HEALTH

FORM NO.680

PERSONAL STATEMENT REGARDING HEALTH

FORM NO.700

PERSONAL STATEMENT REGARDING HEALTH

NORM NO.720

PERSONAL STATEMENT REGARDING HEALTH

ECS

PREMIUM PAYMENT THROUGH ECS - EXISTING POLICIES

ECS

PREMIUM PAYMENT THROUGH ECS - NEW PROPOSALS

ECS - ANNUITY

ANNUITY PAYMENT THROUGH ECS

FORM NO.3260

STANDARD AGE PROOF

SPLITTING. POLS

SPLITTING OF LARGE SUM ASSURED CASES LESS THAN 5 LACS

3237-A

NOMINATION UNDER JEEVAN SATHI POLICY

3251

SPL MHR - ANNEXURE A

3251

SPL MHR - ANNEXURE B

7554

SPECIMEN OF AUTHORISATION LETTER TO RECEIVE POLICY BOND

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