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

The document is an e-Pehchan card for Rajvir Singh, an insured person under the Employees' State Insurance Corporation, containing personal, registration, employer, family, and nominee details. Rajvir is married with two dependents and is employed at EMRI Green Health Services since December 1, 2021. The card serves as proof of registration under the ESI scheme and is required for availing cash or medical benefits.

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rajnnishhh.03
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45 views3 pages

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

The document is an e-Pehchan card for Rajvir Singh, an insured person under the Employees' State Insurance Corporation, containing personal, registration, employer, family, and nominee details. Rajvir is married with two dependents and is employed at EMRI Green Health Services since December 1, 2021. The card serves as proof of registration under the ESI scheme and is required for availing cash or medical benefits.

Uploaded by

rajnnishhh.03
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 : Rajvir Singh Insurance No. : 1507290074


Date of Birth : 02/02/1974 UHID : NA
Gender : Male UAN : NA
Mobile Number : 9414838028 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 11/12/2013 Aadhaar : Verified

REGISTRATION DETAILS

Marital Status : Married Name of Father / : Nihal Singh


Husband
Type Of Disability : NA
Present Address : Ward No.1,Rall Way Colony Permanent Address : Ward No.1,Rall Way Colony
Kalri,Dist:Churu,Rajasthan,331301 Kalri,Dist:Churu,Rajasthan,331
301

Dispensary / : Kolayat Road, Bikaner, RJ (ESIS Disp.) Dispensary / : Rani Bazar, Bikaner, RJ (ESIS
IMP for IP IMP for Family Disp.)

CURRENT EMPLOYER DETAILS

Employer's Code : 52000323050001099 Name of Employer : EMRI GREEN HEALTH


No. SERVICES

Sub Unit's Code : 15520323050011099 Date of : 01/12/2021


No. Appointment

Address of : SIHFW Campus, Jhalana Institutional Branch Office : BO - Jaipur,Kamdhenu


Employer Area,Rajasthan,Dist:JaipurRajasthan3020 Complex,Kamdhenu Complex,
04 Ajmer Road,

FAMILY DETAILS

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


with of Birth Address Aadhaar with IP
IP

Rajasthan /
Sardha Dependant 01/01/2003 NA / NA NA NA No
Choudhary unmarried
Churu
daughter

Page 1 of 3
Name Relation Date UHID/ABHA Number ABHA UAN/ Is Residing State/District
with of Birth Address Aadhaar with IP
IP

Rajasthan /
Rajneh Minor 01/01/2013 NA / NA NA NA No
Choudhary dependant son
Churu

Rajasthan /
Bhateri Devi Spouse 05/02/1982 NA / NA NA Verified No

Churu

Page 2 of 3
NOMINEE DETAILS

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

Ward No.1,Rall Way Colony


Bhateri Devi Spouse NA NA Kalri,RajasthanDist:Churu33 100
1301

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- [Link]

Printed By (Employer/User Name) : EMRI GREEN HEALTH SERVICES


IP Number : 1507290074
Address : Ward No.1,Rall Way Colony Kalri,Dist:Churu,Rajasthan,331301

Date : 17/05/2025 [Link]

Page 3 of 3

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