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Beneficiary Enrolment Form New

Please fill this form to enroll as the beneficiary member of Assam Healthcare Cooperative Society (view Membership Benefits and download the Information Leaflet). You and up to six family members can enroll  via this online form. The membership fee is Rs. 500.00 (LIFELONG) per individual. The fee may be paid in cash or by cheque at our office or via PayTM (75759-27130).

To,
The Chairman Assam Health Care Co-operative Society Ltd., Guwahati-781003

Dear Sir,
I hereby apply to be a beneficiary member of the Assam Health Care Co-operative Society Ltd. I will abide by the provision of the Rules and the By-laws of the Society. I agree to pay the necessary fee.