Download ESIC Form 7B in Word & PDF Formats (Medical Acceptance Card)

ESIC form 7B is known as medical acceptance card, it is required to get treatment in ESIC dispensary.  ESIC form 7B consists of details like your name, IP number, address, establishment name, etc. Insured members can get this form from their employer. If you want to know how a sample ESIC form 7B looks then download the below ESIC form 7B in Word and PDF formats. ( But it is always advisable to get ESI form 7B printout from your employer)

What is ESIC form 7B

ESIC form 7B also known as medical acceptance card.ESIC form 7B is a request form of the insured person to include him or her under a list of a particular doctor in ESIC hospital.

How to Fill ESIC Form 7B

ESIC Form 7B consists of Two parts in a single page. One part consists of insured person details and the other part consists of details of particular under whom the insured person wants to get treatment.

On ESIC form 7B write your name, relationship details like father name or husband name, residential address and insurance number.

ESIC Medical Acceptance Card needs signatures of both the insured person and doctor.

ESIC Form 7B Sample

Sample filled ESIC form 7B

Also Read: How to fill ESIC form 37

How to Download ESIC Form 7B Online

Only your employer can download your ESIC form 7B medical acceptance card in their employer ESIC portal.

Step 1:- To download ESIC form 7B login to employer portal with their establishment code and password at www.esic.in.

Step 2:- After login to this portal, now click on print counter foil under employee.

Step 3:- Now enter ESIC IP number of the insured person and click on the print counter file.

esic form 7b pdf download

Step 4:- Now employee print counterfoil will appear on the screen, at the top left side of the screen a link to download medical acceptance card pdf file or ESIC form 7B pdf download option of that particular employee will be available.

Step 5:- Now click on that link and download ESIC form 7B or ESIC medical acceptance card. Which contains insured person name, insured person’s father name, factory name, residential address of the insured person and IP number of the insured person.

What is The Use of ESIC Form 7B

1. In general ESIC pehchan card or temporary ID card (Print counterfoil) will be enough to get treatment in your ESIC dispensary.

2. But in some cases where the patient needs observation of an ESIC doctor for a long time then they need to submit ESIC form 7B.

8 thoughts on “Download ESIC Form 7B in Word & PDF Formats (Medical Acceptance Card)”

  1. Hi Sir,
    We enrolled our instituion newly to esic portal how can i get the epechchan card and ESIC medical form to give to my employees.

  2. INSURED PERSON SALIL GOSWAMI
    INSURRANCE NO-4112608459
    DATE OF REGISTRATION -07/04/2010

    I REQUEST TO YOU THAT DISPENSARY /IMP FOR FAMILY WILL BE CHANGE
    ESI HOSPITAL ,BIDHANNAGAR DURGAPUR -6

  3. Sir I had updated my Adhar status by own and it also verified .But now I want 2 make e pehchan card .Wats da procedure .After updating Adhar status ?

    • Hi Mehtap,

      You have to take a temporary ESIC card ( print counter foil) from your employer, but before that make sure that your employer has added all your family members details so that they also get ESI benefits.You can staple A5( Half of A4 Sheet) size photo graph of your family members and take your employer signature ( HR or your Manager) on print counter foil. Once you got the temporary ID card visit your regional ESIC office along with your family members. There ESIC officer will take your family photo graph and within 30 days you or your employer can collect your ESIC card from them. In the mean while you can get medicines and treatment in your respective ESIC dispensary with Temporary ESIC Card i.e print counter foil.
      For More Details : https://www.hrcabin.com/get-esic-pehchan-card/

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