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

The document is an e-Pehchan Card for Rakesh Kumar, providing personal, registration, employer, and family details. It includes information such as his insurance number, marital status, and employer's details. The card serves as proof of registration under the Employees' State Insurance scheme and is required for availing benefits.

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adityasharma18888
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64 views2 pages

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

The document is an e-Pehchan Card for Rakesh Kumar, providing personal, registration, employer, and family details. It includes information such as his insurance number, marital status, and employer's details. The card serves as proof of registration under the Employees' State Insurance scheme and is required for availing benefits.

Uploaded by

adityasharma18888
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

EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : RAKESH KUMAR Insurance No. : 6934332335


Date of Birth : 01/01/1986 UHID : HR01.0011025447
Gender : Male UAN : NA
Mobile Number : 8685811455 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 06/01/2024 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : laljeet


Husband
Type Of Disability : NA
Present Address : IMT MANESAR,Dist:Gurgaon,Haryana Permanent Address : tarpur,Dist:Kanpur Dehat,Uttar
Pradesh

Dispensary / : Manesar, HR (ESIS Disp.) Dispensary / : Manesar, HR (ESIS Disp.)


IMP for IP IMP for Family

CURRENT EMPLOYER DETAILS

Employer's Code : 69000582080000999 Name of Employer : PREM ENTERPRISES


No.

Sub Unit's Code : None Date of : 28/12/2023


No. Appointment

Address of : HOUSE NO. 266/A, VILL- KHANDSA, Branch Office : BO - Gurgaon,H.NO.421/7/15,


Employer GURGAON Civil Lines, Near Rajiv Chowk,
HR,Dist:GurgaonHaryana122001 Gurgaon-122001,

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

tarour
laljeet Dependant father NA NA ,kanpur,HaryanaDist:Gurgao 100
n

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) : PREM ENTERPRISES


IP Number : 6934332335
Address : IMT MANESAR,Dist:Gurgaon,Haryana

Date : 22/03/2025 10:01:44

Page 2 of 2

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