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

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    Sudarshan

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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

    Sudarshan
    13 views2 pages

    Original Title

    4114030222

    Copyright

    © © All Rights Reserved

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    PDF, TXT or read online from Scribd

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    Copyright:

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

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

    Uploaded by

    Sudarshan

    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 : KALYAN CHATTERJEE Insurance No. : 4114030222


    Date of Birth : 28/08/1966 UHID : DRP2.0000069997
    Gender : Male UAN : NA
    Mobile Number : 8016038751 ABHA Number : NA
    Email ID : NA ABHA Address : NA
    Registration Date : 10/09/2012 Aadhaar : NA

    REGISTRATION DETAILS

    Marital Status : Married Name of Father / : LATE MIHIR CHATTERJEE


    Husband
    Type Of Disability : NA
    Present Address : VILL- DAKSHIN KHANDA,P.O.- DAKSHIN Permanent Address : VILL- DAKSHIN KHANDA,P.O.-
    KHANDA,P.S.- ANDAL,Dist:West DAKSHIN KHANDA,P.S.-
    Bardhaman,West Bengal,713321 ANDAL,Dist:West
    Bardhaman,West
    Dispensary / : Durgapore-II, WB (ESIS Disp.) Dispensary / Durgapore-II, WB (ESIS Disp.)
    : Bengal,713321
    IMP for IP IMP for Family

    CURRENT EMPLOYER DETAILS

    Employer's Code : 74000504570001001 Name of Employer : HYDRO TECH ENGINEERS


    No.

    Sub Unit's Code : None Date of : 01/11/2023


    No. Appointment

    Address of : C/O SISIR KUMAR Branch Office : BO - DURGAPUR


    Employer GHOSH,SARATPALLY, (Birbhum),E.S.I. Hospital
    Complex, Dr.NAZakir Hussain

    FAMILY DETAILS

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


    with of Birth Address Aadhaar with IP
    IP

    West Bengal /
    TULURANI Spouse 14/11/1978 NA Yes
    CHATTERJEE
    West Bardhaman

    Page 1 of 2
    West Bengal /
    KANKANA Dependant 04/10/2004 NA Yes
    CHATTERJEE unmarried
    West Bardhaman
    daughter

    NOMINEE DETAILS

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

    VILL- DAKSHIN
    TULURANI Spouse NA NA KHANDA,P.O.- DAKSHIN 100
    CHATTERJEE KHANDA,P.S.-
    ANDAL,West
    BengalDist:West
    Bardhaman713321

    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) : HYDRO TECH ENGINEERS


    IP Number : 4114030222
    Address : VILL- DAKSHIN KHANDA,P.O.- DAKSHIN KHANDA,P.S.- ANDAL,Dist:West
    Bardhaman,West Bengal,713321
    Date : 09/11/2023 7:56:38AM

    Page 2 of 2

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