TRANS NZOIA COUNTY GOVERNMENT MEDICAL COVER

NO. EMPLOYEE NAME DEPENDANT NAME GENDER RELATION TO JOB MOBILE I/D NO. PERSONAL E-MAIL ADDRESS
EMPLOYEE GROU NUMBER NUMBER
P

Points to Note

a) All required details must be clearly indicated i.e. date of birth, gender;
b) Family size is M+5 i.e. Principal Member + 5 dependents’ (Nuclear Family);
c) Provide National ID for BOTH Principal and Spouse, children provide birth certificate or birth notification;
d) A widow or a widower will add one more dependent to make it 5.