EMPLOYEES' STATE INSURANCE CORPORATION
e-Pehchan Card
PERSONAL DETAILS
Name of IP : SUBASH DAS Insurance No. : 3317618925
Date of Birth : 03/04/1996 UHID : MH01.0022297254
Gender : Male UAN : NA
Mobile Number : 9354662065 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 29/05/2025 Aadhaar : NA
REGISTRATION DETAILS
Marital Status : Unmarried Name of Father / : SHYAM DAS
Husband
Type Of Disability : NA
Present Address : CHAKAN,Dist:Pune,Maharashtra Permanent Address : CHAKAN,Dist:Pune,Maharashtr
a
Dispensary / : Chakan, MH (ESIS Disp.) Dispensary / : Chakan, MH (ESIS Disp.)
IMP for IP IMP for Family
CURRENT EMPLOYER DETAILS
Employer's Code : 25000073580001019 Name of Employer : SAI MULTI SERVICES
No.
Sub Unit's Code : 33250073580011019 Date of : 28/05/2025
No. Appointment
Address of : SHOP NO. 1 UDYOG Branch Office : BO - Chakan,ESIC Branch
Employer INDRAKAMAL,BEED BY PASS Office, Gate No-1173, 1st Floor,
ROAD Dist:Chhatrapati 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
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NOMINEE DETAILS
UHID/
Name of Nominee Relation with IP Date of Birth Address of Nominee Percentage(%)
ABHA Number
AS
SHYAM DAS Dependant father NA NA ABOBV,MaharashtraDist:Pu 100
ne
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) : SAI MULTI SERVICES
IP Number : 3317618925
Address : CHAKAN,Dist:Pune,Maharashtra
Date : 29/05/2025 11:20:02
Page 2 of 2
