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

The document is an e-Pehchan card for Manoj Kumar, an insured person under the Employees' State Insurance Corporation, detailing his personal, registration, employer, and family information. It includes his insurance number, marital status, current employer, and nominee details. The card serves as proof of registration under the ESI scheme and is required for availing cash and medical benefits.

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office
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37 views2 pages

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

The document is an e-Pehchan card for Manoj Kumar, an insured person under the Employees' State Insurance Corporation, detailing his personal, registration, employer, and family information. It includes his insurance number, marital status, current employer, and nominee details. The card serves as proof of registration under the ESI scheme and is required for availing cash and medical benefits.

Uploaded by

office
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : MANOJ KUMAR Insurance No. : 1115633136


Date of Birth : 02/10/1978 UHID : NA
Gender : Male UAN : 101524796926
Mobile Number : 9811949699 ABHA : NA
Email ID : NA PHR Address : NA
Registration Date : 09/11/2019 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : prempal singh


Husband
Type Of Disability : NA
Present Address : chalera,gali no. 2, sec 44,Dist:Gautam Permanent Address : ukhlana,aligarh,Dist:Aligarh,Uttar
Buddha Nagar,Uttar Pradesh,201301 Pradesh,202125

Dispensary / : Greater Noida, UP (ESIC Disp.) Dispensary /


: Hospital campus, Sasni Gate,
IMP for IP IMP for Family
Aligarh, UP (ESIS Disp.)

CURRENT EMPLOYER DETAILS

Employer's Code : 69000705240000999 Name of Employer : LH RISK MANAGEMENT


No. PRIVATE LIMITED

Sub Unit's Code : 15690705240010999 Date of : 12/02/2022


No. Appointment

Address of : D - 1302, ROSEWOOD,SIRSI Branch Office : BO - Jaipur,Jaipur


Employer ROAD,JAIPUR,Dist:JaipurRajasthan30201 (Neharu Place),
2

FAMILY DETAILS

Relation
Date UAN/
Name with UHID/ABHA PHR Address State/District
of Birth Aadhaar
IP

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NOMINEE DETAILS

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

ukhlana,Uttar
niraj devi Spouse NA NA PradeshDist:Aligarh202125 100

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) : LH RISK MANAGEMENT PRIVATE LIMITED


IP Number : 1115633136
Address : chalera,gali no. 2, sec 44,Dist:Gautam Buddha Nagar,Uttar Pradesh,201301

Date : 12/11/2022 2:51:45PM

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