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    4406747778

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    biswaranjanb288

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    © All Rights Reserved
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    4406747778

    Uploaded by

    biswaranjanb288
    4 views2 pages

    Copyright

    © © All Rights Reserved

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    Copyright:

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

    4406747778

    Uploaded by

    biswaranjanb288

    Copyright:

    © All Rights Reserved
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    You are on page 1of 2

    EMPLOYEES' STATE INSURANCE CORPORATION

    e-Pehchan Card

    PERSONAL DETAILS

    Name of IP : YERRA LAXMAN Insurance No. : 4406747778


    Date of Birth : 01/01/2002 UHID : NA
    Gender : Male UAN : NA
    Mobile Number : 9785852520 ABHA Number : NA
    Email ID : NA ABHA Address : NA
    Registration Date : 11/03/2024 Aadhaar : NA

    REGISTRATION DETAILS

    Marital Status : Unmarried Name of Father / : DEENABANDU


    Husband
    Type Of Disability : NA
    Present Address : SHRAMIK VIHAR Permanent Address : 17-132 , CHINNA YARRA
    NISHA,Dist:Angul,Odisha,759111 GOVINDA PUTTUGA
    KAVITI,Dist:Srikakulam,Andhra
    Pradesh,532322
    Dispensary / : Angul, OR (ESIS Disp.) Dispensary / : Angul, OR (ESIS Disp.)
    IMP for IP IMP for Family

    CURRENT EMPLOYER DETAILS

    Employer's Code : 52000126070001099 Name of Employer : TATA PROJECTS LIMITED


    No.

    Sub Unit's Code : 44520126070021099 Date of : 17/03/2024


    No. Appointment

    Address of : Tata Projects Limited, C/o Jindal Steel Branch Office : BO - Angul,Branch Office, ESI
    Employer and Power Limited,At- Nisha PO- Jindal Corporation, H/o Sri B. B.
    Biswal,Bada Bazar (Bhagabati

    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

    17-132 , CHINNA YARRA


    DEENABANDU Dependant father NA NA GOVINDA PUTTUGA 100
    KAVITI,Andhra
    PradeshDist:Srikakulam5323
    22

    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) : TATA PROJECTS LIMITED


    IP Number : 4406747778
    Address : SHRAMIK VIHAR NISHA,Dist:Angul,Odisha,759111

    Date : 17/03/2024 9:31:58PM

    Page 2 of 2

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