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

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.

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.

Also Find:

What is ESIC Form 37 and How to Download it