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Award Nomination Form

Prerequisites:

Healthcare Innovation Awards 2020
Elets Technomedia Pvt. Ltd.
Stellar IT Park
7A/7B, 5th floor, Annexe Tower
C-25, Sector 62, Noida
Uttar Pradesh 201301

Contact us for Award Nomination:

  Vikram Singh, +91-90132-15496, vikram.singh@elets.co.in
  Neha Pal, +91-95601-26763, nehapal@ehealthonline.org

1. For Online Payment :

Beneficiary Name Elets Technomedia Pvt. Ltd.
Beneficiary Address Stellar IT Park, 7A/7B, 5th Floor, Tower-B,
C-25, Sector-62, Noida, U.P.-201301
Beneficiary Bank A/C No 158005001238
Beneficiary Bank Name ICICI Bank
Beneficiary Bank Address SG – 7, Stellar IT Park, C - 25, Sector – 62, Noida, U.P. – 201301
RTGS / NEFT IFSC Code ICIC0001580
MICR Code 110229152
SWIFT Code ICICINBBCTS
Branch Code 001580

2. Before filling the award nomination form you need to have the scanned copy of below listed documents.

a) Authorisation Certificate. (click here to download)

  • For Private Orgainsations working with Government Departments -
    Authorisation Certificate should be signed by the Government Department with which the organisation is working for the nominated project.

3. Award Nomination Fee

 Hospitals:  30000 + GST(23.9%) = INR 37,170/-
 Corporate:  50000 + GST(23.9%) = INR 61,950/-
Note: GST 18% + (Online Bank Transfer Charges + Transfer GST charges) @ 5.9% = 23.9%