REQUEST HEALTH CARD – CNS PIN, PUK AND CIP CODES
IN ORDER TO READ THE NCS, A SMART CARD READER MUST BE INSTALLED IN THE PC
The undersigned
Applicant’s surname
Applicant’s name
Applicant’s tax code
Applicant’s date of birth
Applicant’s residence (Enter full address)
Select an option
30010 - Campagna Lupia
30010 - Campolongo Maggiore
30010 - Camponogara
30014 - Cavarzere
30015 - Chioggia
30010 - Cona
30031 - Dolo
30032 - Fiesso dArtico
30030 - Fossò
30020 - Marcon
30030 - Martellago
30034 - Mira
30035 - Mirano
30033 - Noale
30030 - Pianiga
30020 - Quarto dAltino
30030 - Salzano
30036 - Santa Maria di Sala
30037 - Scorzè
30038 - Spinea
30039 - Stra
30121 - Venezia
30122 - Venezia
30123 - Venezia
30124 - Venezia
30125 - Venezia
30126 - Lido e Pellestrina
30132 - Venezia
30133 - Venezia
30135 - Venezia
30141 - Murano
30142 - Burano
30171 - Mestre Venezia
30172 - Mestre Venezia
30173 - Favaro Venezia
30174 - Chirignago Cipressina Trivignano Zelarino
30174 - Carpenedo Terraglio
30175 - Marghera Venezia
30176 - Marghera Venezia
30030 - Vigonovo
City / Competent District
Applicant’s E-mail
Applicant’s telephone number
Applicant’s Identity Document front and backside
Any other attachment
Applicant’s Health Card front and backside
Any other attachment
Select an option
For himself/herself
For his/her relatives
Requests
Under-18 relatives’ data
Surname
Name
Date of Birth
Relationship
Aware that pursuant to art. 76 of DPR 445/2000 the release of false declarations is punished according to the Criminal Code and special laws on the matter
Download the form at the following
LINK
Compiled request form
Send
