Department of Urban Dev and Municipal Affairs(T&CP)

Dept Of Urban Dev. And Municipal Affairs

Nagarayan,DF-8,Sector-I, Salt Lake, Kolkata-64.
(172HO001)
Certificate for Enrolment under West Bengal Health Scheme
Memo No: 172HO001/114/2023 Date: 10/08/2023

Information of Employee
1. Name (In Block Letter) SAROJ KUMAR GOLDER 2. HRMS ID 1995004782

3. Enrolment ID No. WB/EMP/05/000060564 4. GPF No. ADMN/WB/70665

Date of Entry into

5. Designation of Employee OFFICER ON SPECIAL DUTY 6. 20/03/1995
Government Service
Vill. & P.O. Thakurnagar, Dist. North
7. Address of Employee 24-Pgs, PIN-743287 8. Date of Superannuation 31/01/2029

Hospital Accommodation Entitlement :

1. Pay Bed in Government Hospital run by Govt. of West Bengal DOUBLE OCCUPANCY LARGE CABIN
2. Tata Medical Centre, Rajarhat GENERAL
3. Other Private Empanelled HCOs SEMI-PRIVATE

Information of All Beneficiaries (Including Employee)

Beneficiary ID : ADMN/WB/70665/1/3 Enrollment w.e f. : 01/12/2010
Relation with Employee : SELF Mobile No : 9635809205
SAROJ KUMAR Date of Birth : 13/01/1969
1 E-mail :
GOLDER Blood Group : O+ sarojgol2019@gmail.com
Aadhaar No : 592256230665
Beneficiary ID : ADMN/WB/70665/2/3 Enrollment w.e f. : 01/12/2010
Relation with Employee : WIFE Mobile No :
2 AVA GOLDER Date of Birth : 26/11/1971 E-mail :
Blood Group : A+ Aadhaar No : 425496617621
Beneficiary ID : ADMN/WB/70665/3/3 Enrollment w.e f. : 01/12/2010
Relation with Employee : SON(UPTO Mobile No :
3 SOUVIK GOLDER 25 YEARS) E-mail :
Date of Birth : 19/11/2000 Aadhaar No : 599226716495
Blood Group : B+

Certified that above mentioned employee has been enrolled under the ³West Bengal Health Scheme´along
with above mentioned family members to get medical treatment under the scheme.

Digitally signed by RAJIB

SENGUPTA

RAJIB DN:CN=RAJIB SENGUPTA,

SERIALNUMBER=beb30ab725f3b0
4b4be4f97730a302ea064960e1693a
8d74be728ee6e3af19b3, ST=WEST
BENGAL, OID.2.5.4.17=700064,

SENG OID.2.5.4.20=73B1932331E01F382
5824A81A62B782D73C58FB6DAE2
441B8DD578C249DB1A42,
OID.2.5.4.65=cd9cce152880c8c15a

Name (Block Letter): RAJIB SENGUPTA 1f0f48d1c217a9, OU=ASSISTANT

UPTA
SECRETARY, O=DEPARTMENT
OF URBAN DEVELOPMENT AND
MUNICIPAL AFFAIRS SALTLAKE,
C=IN
Reason:Certified True Copy
Date:10/08/2023 13:54:37

Designation: Assistant Secretary

Digitally Signed. Does not require any Ink Signature.