Membership Registration & Card Application — Swasthya Sanjeevani Healthcare Foundation

Registration

Member Registration Form

Select Member Card to Join

Choose your membership card type below. You can apply for a Beneficiary Health Card or an Official Member ID Card.

Instant Digital Issuance

Beneficiary Health Card

POPULAR

Cashless health camp coverage, OPD/IPD medical network discounts, Individual, Family (5 members) & Student plans.

Hospital Network Family Covered Instant QR Card

Official Member ID Card

EXECUTIVE

Join as active registered organization representative. Receive executive ID card, appointment certificate & voting access.

Official ID Card Certificate Active Role

Select Membership Plan *

Designation *

Name *

Gender *

Date of Birth *

S/o, D/o, W/o *

Password *

Email *

Working Area *

Profession

Blood Group

Healthcare Beneficiary Card Details

Emergency hospital preference and contact details for your digital health card

Preferred Hospital / Camp Center * Primary center for accessing checkup camps, OPD assistance & health benefits

Emergency Contact Person

Emergency Contact Phone

Family Covered Dependents (Up to 5 Members)

Cover your spouse, children, or elderly parents under this single card.

Member Name *	Relationship *	Age *	Gender *	Blood Group	Aadhaar (Optional)	Action

All covered family members will be printed on the back of the health card and registered in the health database.

Mobile No. *

Aadhaar No. *

State *

District *

Pin Code *

Address *

Profile Picture *

Aadhaar Card (Front) *

Aadhaar Card (Back) *

Select Payment Method *

Card / UPI / Net Banking

UPI / Bank / Cash

Make my membership recurring (automatically renew annually)