ODCHC HIS

ONDO STATE
CONTRIBUTORY HEALTH COMMISSION
(ODCHC)

© 2025 ODCHC

Beneficiary Enrollment

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*Plan Type

Title

*First Name

Other Name

*Last Name

Email Address

*Mobile Number

*Date of Birth

Age

*Gender

Male

Female

*Marital Status

*Residential Address

*State

*LGA of Residence

*Ward

*Provider

*State of Origin

*LGA of Origin

Nationality

*Level of Education

Religion

Tribe

Occupation

NIN

Are you on the National Health Insurance Scheme?

Yes

Medical History: Tick all pre-existing conditions that applies

Surgical History

Next of Kin Information

*Last Name

*First Name

Other Name

*Relationship

*Mobile Number

*Contact Address

*State

*LGA

Spouse Information

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Last Name

First Name

Date of Birth

No of Children

Access to this System by anyone other than the intended user is prohibited. The information contained within may be privileged or otherwise protected by work product immunity or other legal rules. If you have received access to the system by mistake, please immediately contact InStrat at info@instratghs.com