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    6933563083

    Uploaded by

    Randeep Sarkar

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd

    6933563083

    Uploaded by

    Randeep Sarkar
    3 views2 pages

    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
    3 views2 pages

    6933563083

    Uploaded by

    Randeep Sarkar

    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 : RANDEEP SARKAR Insurance No. : 6933563083


    Date of Birth : 21/06/1995 UHID : NA
    Gender : Male UAN : NA
    Mobile Number : 7002615916 ABHA Number : NA
    Email ID : NA ABHA Address : NA
    Registration Date : 31/05/2023 Aadhaar : NA

    REGISTRATION DETAILS

    Marital Status : Unmarried Name of Father / : Rabindra Sarkar


    Husband
    Type Of Disability : NA
    Present Address : GURGOAN,Dist:Gurgaon,Haryana Permanent Address : GURGOAN,Dist:Gurgaon,Harya
    na

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


    IMP for IP IMP for Family Disp.)

    CURRENT EMPLOYER DETAILS

    Employer's Code : 67000504930001099 Name of Employer : ETEAM INFOSERVICES


    No. PRIVATE LIMITED

    Sub Unit's Code : 69670504930011099 Date of : 22/05/2023


    No. Appointment

    Address of : HOUSE NO 1088,2ND FLOOR,,SECTOR Branch Office : BO - Gurgaon,H.NO.421/7/15,


    Employer 39,GURGAON Civil Lines, Near Rajiv Chowk,
    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

    GURGOAN,HaryanaDist:Gur
    Rabindra Sarkar Dependant father NA NA gaon 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) : ETEAM INFOSERVICES PRIVATE LIMITED


    IP Number : 6933563083
    Address : GURGOAN,Dist:Gurgaon,Haryana

    Date : 21/03/2024 5:15:14PM

    Page 2 of 2

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