CBWAI - Register

Name *

Date of Birth *

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Other

Mobile Number *

Email Address

CGHS ID *

CGHS Wellness City *

Wellness Center *

Ministry *

Category *

Retired

Others

Spouse Name

Spouse CGHS ID

Spouse Date of Birth

Total Family Beneficiaries *

Photo * [.jpg, .jpeg, .png; size : upto 2MB ]

Subscription Fee

Donation Amount

Please enroll me as member in CBWAI. I do hereby authorize CBWAI to use my above information for official purpose. I understand that amount paid by me is non-refundable. I assure that I shall abide by the rules and regulations of CBWAI, issued from time to time.

CGHS BENEFICIARIES WELFARE ASSOCIATION OF INDIA - (CBWAI)
Regd No. S/RS/KH(SW)/99/2021 * NITI AAYOG No. DL/2025/0819793
CBWAI

Member Registration Form