S080_Child - Individual CLA

SED API version: 0.14.2 PREVIEW build 3
Model version: 4.0.16


















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Please fill in the following if "Entitlement document" = "01 - EHIC - European Health Insurance Card" :
Please fill in the following if "Entitlement document" = "02 - PRC Provisional Replacement Certificate", "04 - S2 Entitlement to scheduled treatment", "08 - S045 Entitlement document - Temporary Stay" or "12 - E112 Certificate concerning the retention of the right to sickness or maternity benefits" :
Please fill in the following if "Entitlement document" = "02 - PRC Provisional Replacement Certificate", "04 - S2 Entitlement to scheduled treatment", "08 - S045 Entitlement document - Temporary Stay" or "12 - E112 Certificate concerning the retention of the right to sickness or maternity benefits" :





Fixed period*
Open period*







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