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Construction Worker Medical Assistance
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Checklist of the documents required for Medical Assistance Benefit Form.
1. ABOCWWB Id Card
2. Bank passbook first page
3. Copy Of Payslip Of Account Paybook Showing Monthly Contribution Deposited
4. Accident Report From The Employer/Principal Employer/Local Police Authority
5. All Documents Of Treatment In Govt Hospital Upload 1
6. Photo Of The Part Of The Person Effected Due To Accident
7. Percentage Of Disability Certificate From The Appropriate Authority
8. Signature
All
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Textbox are mandatory
Date
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District Office
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Asst. Labour Commissioner, Kamrup (Metro)
Office of the Labour Officer, Barpeta
Office of the Labour Officer, Nalbari
Office of the Labour Inspector, Rangia
Office of the Labour Inspector, Chaygaon
Office of the Labour Inspector, Bhawanipur
Office of the Labour Inspector, Rupsi
Office of the Asst. Labour Commissioner, Golaghat
Office of the Labour Officer, Bokakhat
Office of the Labour Officer, Bokajan
Office of the Labour Inspector, Sarupathar
Office of the Asst. Labour Commissioner, Sivasagar
Office of the Labour Officer, Sonari
Office of the Labour Inspector, Demow
Office of the Labour Inspector, Nazira
Office of the Asst. Labour Commissioner, Dibrugarh
Office of the Labour Inspector, Khowang
Officer of the Asst. Labour Commissioner, Tinsukia.
Office of the Labour Officer, Margherita
Office of the Labour Inspector, Hapjan
Office of the Labour Inspector, Kakopathar
Office of the Asst. Labour Commissioner, Jorhat
Office of the Labour Inspector, Majuli
Office of the Labour Inspector, Titabor
Office of the Asst. Labour Commissioner, Nagaon
Office of the Labour Officer, Morigaon
Office of the Labour Officer, Diphu
Office of the Labour Officer, Hojai
Office of the Labour Officer, Hamren
Office of the Labour Inspector , Batadraba
Office of the Labour Inspector , Kaliabor
Office of the Labour Inspector , Mayong
Office of the Labour Inspector , Rongkhong
Office of the Labour Inspector , Howraghat
Office of the Asst. Labour Commissioner, Tezpur
Office of the Labour Officer, Biswanath Chariali
Office of the Labour Officer, Lakhimpur
Office of the Labour Officer, Mangaldoi
Office of the Labour Officer, Dhemaji
Office of the Labour Inspector, Dhekiajuli
Office of the Labour Inspector, Behali
Office of the Labour Inspector, Narayanpur
Office of the Labour Inspector, Nowboicha
Office of the Asst. Labour Commissioner, Dhubri
Office of the Labour Officer, Bongaigaon
Office of the Labour Officer, Goalpara
Office of the Labour Inspector, Dudhnoi
Office of the Labour Inspector, Bilashipara
Office of the Labour Inspector, Mancachar
Office of the Labour Officer (Under BTAD) , Kokrajhar
Office of the Labour Inspector, Majbat
Office of the Labour Inspector, Khoirabari
Office of the Labour Inspector, Gossaigaon
Office of the Asst. Labour Commissioner, Silchar
Office of the Labour Officer, Karimganj
Office of the Labour Officer, Hailakandi
Office of the Labour Officer, Haflong
Office of the Labour Inspector, Patharkandi
Office of the Labour Inspector, Lakhipur
Labour inspector- Jatinga valley
Labour Inspector- Diyung valley
Labour inspector- Udarbond
Asst. Labour Commissioner, Kamrup (Rural)
Office of the Labour Officer, Udalguri
Office of the Labour Officer, Chirang
Office of the Labour Officer, Baksa
Office of the Labour Inspector, NAHARKATIA
Name Of The Applicant
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Mobile Number
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Address
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Registration No
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Date of Registration
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Id Card
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Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed
Age
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Date of First Payment Of Contribution
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Date of Last Payment Of Contribution
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Total Amount Of Contribution Remitted
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Details Regarding Disease/Surgery/Accident
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Disability If Any Due To The Disease/Surgery/Accident
Name Of The Govt Hospital
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Hospital Address Were Admitted
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Period Of Treatment As Indoor Patient In Govt Hospital
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Date of Admission In The Hospital
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Date of Discharge In The Hospital
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Details Of Medical Benefit Received If Any, Earlier
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Name Of The Bank Of The Applicant
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Account No Of The Applicant
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Bank Branch Name
Bank IFSC Code
Attested Copy Of Id Card
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Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed
Bank passbook first page
*
Choose file
Maximum File size allowed is 1MB
Only pdf,png,jpeg images and pdf file type allowed
Copy Of Payslip Of Account Paybook Showing Monthly Contribution Deposited
*
Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed
Accident Report From The Employer/Principal Employer/Local Police Authority
*
Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed
All Documents Of Treatment In Govt Hospital Upload 1
*
Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed
All Documents Of Treatment In Govt Hospital Upload 2
*
Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed
All Documents Of Treatment In Govt Hospital Upload 3
Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed
Photo Of The Part Of The Person Effected Due To Accident
Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed
Percentage Of Disability Certificate From The Appropriate Authority
Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed
Declaration
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Signature
*
Choose file
Maximum File size allowed is 1MB
Only pdf,png and jpeg images allowed