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    Employees' State Insurance Corporation E-Pehchan Card: Personal Details

    Uploaded by

    Shiv Kumar
    This document contains personal and employment details of Shiv Kumar who is registered under the Employees' State Insurance Corporation (ESIC) scheme. It provides his insurance number, date of birth, employer information including the name and address of Sun Services Forklift Pvt. Ltd. where he works. It also lists his family details and nominee as his dependent father Tuntun Ray.

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    Employees' State Insurance Corporation E-Pehchan Card: Personal Details

    Uploaded by

    Shiv Kumar
    86 views2 pages
    This document contains personal and employment details of Shiv Kumar who is registered under the Employees' State Insurance Corporation (ESIC) scheme. It provides his insurance number, date of birth, employer information including the name and address of Sun Services Forklift Pvt. Ltd. where he works. It also lists his family details and nominee as his dependent father Tuntun Ray.

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    Download it repair manual

    Original Title

    6721652994-1

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    This document contains personal and employment details of Shiv Kumar who is registered under the Employees' State Insurance Corporation (ESIC) scheme. It provides his insurance number, date of birth, employer information including the name and address of Sun Services Forklift Pvt. Ltd. where he works. It also lists his family details and nominee as his dependent father Tuntun Ray.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    86 views2 pages

    Employees' State Insurance Corporation E-Pehchan Card: Personal Details

    Uploaded by

    Shiv Kumar
    This document contains personal and employment details of Shiv Kumar who is registered under the Employees' State Insurance Corporation (ESIC) scheme. It provides his insurance number, date of birth, employer information including the name and address of Sun Services Forklift Pvt. Ltd. where he works. It also lists his family details and nominee as his dependent father Tuntun Ray.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 2

    EMPLOYEES' STATE INSURANCE CORPORATION

    e-Pehchan Card

    PERSONAL DETAILS

    Name of IP : SHIV KUMAR Insurance No. : 6721652994


    Date of Birth : 01/01/1993 UHID : BR01.0001546844
    Gender : Male UAN : NA
    Mobile Number : 7352632878 ABHA Number : NA
    Email ID : NA ABHA Address : NA
    Registration Date : 16/11/2022 Aadhaar : NA

    REGISTRATION DETAILS

    Marital Status : Unmarried Name of Father / : TUNTUN RAY


    Husband
    Type Of Disability : NA
    Present Address : KISHUNPUR TELAUR VAISHALI Permanent Address : KISHUNPUR TELAUR
    BIHAR,Dist:Vaishali,Bihar VAISHALI
    BIHAR,Dist:Vaishali,Bihar

    Dispensary / : D 1 Ankleshwear, GJ (ESIS Disp.) Dispensary / : D 1 Ankleshwear, GJ (ESIS


    IMP for IP IMP for Family Disp.)

    CURRENT EMPLOYER DETAILS

    Employer's Code : 33000168020000606 Name of Employer : SUN SERVICES FORKLIFT


    No. PVT.LTD.

    Sub Unit's Code : None Date of : 11/06/2023


    No. Appointment

    Address of : S-50,S Branch Office : BO - Chakan,ESIC Branch


    Employer BLOCK,MIDC,Dist:PuneMaharashtra4110 Office, Gate No-1173, 1st Floor,
    Datta Nagari, Near Sadhana

    FAMILY DETAILS

    Name Relation Date UHID/ABHA Number ABHA UAN/ Is Residing State/District


    with of Birth Address Aadhaar with IP
    IP

    Page 1 of 2
    NOMINEE DETAILS

    UHID/
    Name of Nominee Relation with IP Date of Birth Address of Nominee Percentage(%)
    ABHA Number

    KISHUNPUR TELAUR
    TUNTUN RAY Dependant father NA NA VAISHALI 100
    BIHAR,BiharDist:Vaishali

    Affix Your Family Photograph Here. (Attested and Stamped by


    Employer / ESIC Official)

    Signature / LTI of Registered Employee / IP

    Signature / Stamp of ESIC Officer / Employer

    Note:
    · This e-Pehchan card affixed with photograph of family & duly attested by the Employer/ESIC Staff shall be requested for
    availing cash/medical benefit.
    · e-Pehchan card is a proof of registration under ESI scheme. However eligibility for various benefits depends upon the
    contribution conditions. For further information on eligibility to various Benefits, please visit- www.esic.in

    Printed By (Employer/User Name) : SUN SERVICES FORKLIFT PVT.LTD.


    IP Number : 6721652994
    Address : KISHUNPUR TELAUR VAISHALI BIHAR,Dist:Vaishali,Bihar

    Date : 20/06/2023 11:02:38AM

    Page 2 of 2

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