4407203365

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EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : SADANANDA BHOI Insurance No. : 4407203365


Date of Birth : 01/01/1975 UHID : OR01.0004208577
Gender : Male UAN : NA
Mobile Number : 9937979816 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 21/01/2025 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : sanhali bhoi


Husband
Type Of Disability : NA
Present Address : SANKARPRATAPPUR,GADASILA,DHEN Permanent Address : SANKARPRATAPPUR,GADASI
KANAL,Dist:Dhenkanal,Odisha LA,DHENKANAL,Dist:Dhenkan
al,Odisha

Dispensary / : ESI Dispensary, Meramundali Dispensary / : ESI Dispensary, Meramundali


IMP for IP IMP for Family

CURRENT EMPLOYER DETAILS

Employer's Code : 44000185620001001 Name of Employer : OMM CONSTRUCTION


No.

Sub Unit's Code : None Date of : 21/01/2025


No. Appointment

Address of : AT-AMALAPADA,GANDHIMARG,PO/PS- Branch Office : BO - Angul,Branch Office, ESI


Employer ANGUL,Dist:AngulOdisha759122 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

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NOMINEE DETAILS

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

SANKARPRATAPPUR,GAD
DEBDANI BHOI Spouse NA NA ASILA,DHENKANAK,Odisha 100
Dist:Dhenkanal

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) : OMM CONSTRUCTION


IP Number : 4407203365
Address : SANKARPRATAPPUR,GADASILA,DHENKANAL,Dist:Dhenkanal,Odisha

Date : 21/01/2025 08:46:35

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