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SECTION I: EMPLOYER ACCOUNT HOLDER DETAILS


SECTION II: MEMBER DETAILS



SECTION III: PLEASE SELECT PLAN


SECTION IV: DETAILS OF YOUR GENERAL PRACTITIONER


SECTION V: DEPENDANTS INFORMATION
Name DOB ID No Gender Relationship Mobile Number


SECTION IV: BANKING DETAILS



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Fill in the forms and email to membership@cellmed.co.zw.

You can also send physically to:

CellMed Health Medical Fund

The Honey Comb
5th Floor Finsure House
84-86 Kwame Nkrumah Avenue

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