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

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    rupasana157
    This document contains personal and employment details for an individual named Suman Roy with insurance number 4117427104. It includes his address, date of birth, employer information, family details including father Dipak Roy and mother Shafali Roy, and nominee details naming Dipak Roy. The document is an e-Pehchan card from the Employees' State Insurance Corporation providing proof of registration under the ESI scheme.

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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

    rupasana157
    41 views2 pages
    This document contains personal and employment details for an individual named Suman Roy with insurance number 4117427104. It includes his address, date of birth, employer information, family details including father Dipak Roy and mother Shafali Roy, and nominee details naming Dipak Roy. The document is an e-Pehchan card from the Employees' State Insurance Corporation providing proof of registration under the ESI scheme.

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    4117427104 (1)

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    This document contains personal and employment details for an individual named Suman Roy with insurance number 4117427104. It includes his address, date of birth, employer information, family details including father Dipak Roy and mother Shafali Roy, and nominee details naming Dipak Roy. The document is an e-Pehchan card from the Employees' State Insurance Corporation providing proof of registration under the ESI scheme.

    Copyright:

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

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

    Uploaded by

    rupasana157
    This document contains personal and employment details for an individual named Suman Roy with insurance number 4117427104. It includes his address, date of birth, employer information, family details including father Dipak Roy and mother Shafali Roy, and nominee details naming Dipak Roy. The document is an e-Pehchan card from the Employees' State Insurance Corporation providing proof of registration under the ESI scheme.

    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 : SUMAN ROY Insurance No. : 4117427104


    Date of Birth : 15/11/1989 UHID : DBRH.0000008418
    Gender : Male UAN : NA
    Mobile Number : 9831842873 ABHA Number : NA
    Email ID : NA ABHA Address : NA
    Registration Date : 18/02/2020 Aadhaar : Verified

    REGISTRATION DETAILS

    Marital Status : Unmarried Name of Father / : DIPAK ROY


    Husband
    Type Of Disability : NA
    Present Address : 12/13 Biharilal Pal Street,Kolkata Permanent Address : 12/13 Biharilal Pal
    -36,Dist:North 24 Pargana,West Street,Kolkata -36,Dist:North
    Bengal,700036 24 Pargana,West
    Bengal,700036
    Dispensary / : Barahnagar, WB (ESIS Disp.) Dispensary / : Barahnagar, WB (ESIS Disp.)
    IMP for IP IMP for Family

    CURRENT EMPLOYER DETAILS

    Employer's Code : 56001007240001002 Name of Employer : J.G.HOSIERY PVT LTD.


    No.

    Sub Unit's Code : 41561007240031002 Date of : 09/02/2020


    No. Appointment

    Address of : 28, B.T.Road,Cossipore, Lohia Branch Office : BO - COSSIPORE,46/1- G,


    Employer press,Dist:KolkataWest Bengal700002 B.T. ROAD, KOLKATA Â? 700
    002,0 NA

    FAMILY DETAILS

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


    with of Birth Address Aadhaar with IP
    IP

    West Bengal /
    Dipak Roy Dependant 01/10/1961 HKMR.0000027877/ NA Yes
    father NA
    North 24 Pargana

    Page 1 of 2
    West Bengal /
    Shafali Roy Dependant 02/08/1970 NA Yes
    mother
    North 24 Pargana

    NOMINEE DETAILS

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

    12/13 Biharilal Pal


    DIPAK ROY Dependant father NA NA Street,Kolkata - 100
    700036,West
    BengalDist:North 24 Pargana

    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) : J.G.HOSIERY PVT LTD.


    IP Number : 4117427104
    Address : 12/13 Biharilal Pal Street,Kolkata -36,Dist:North 24 Pargana,West Bengal,700036

    Date : 16/01/2024 12:48:11PM

    Page 2 of 2

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