4941184015DHANALAKSHMI

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EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : DHANALAKSHMI Insurance No. : 4941184015


Date of Birth : 12/09/1979 UHID : NA
Gender : Female UAN : NA
Mobile Number : 9731665176 ABHA : NA
Email ID : NA PHR Address : NA
Registration Date : 09/03/2023 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : VENKATESH P


Husband
Type Of Disability : NA
Present Address : NO 64 2ND MAIN ROAD CROSS JAI Permanent Address : NO 64 2ND MAIN ROAD
BHUVANESWARI NAGAR,NANDINI CROSS JAI BHUVANESWARI
LAYOUT BANGALORE NAGAR,NANDINI LAYOUT
560096,Dist:Bangalore,Karnataka BANGALORE
Dispensary / : Rajajinagar I, KA (ESIS Disp.) Dispensary / : Rajajinagar I, KA (ESIS Disp.)
560096,Dist:Bangalore,Karnata
IMP for IP IMP for Family ka

CURRENT EMPLOYER DETAILS

Employer's Code : 49000518630000699 Name of Employer : UNITED PRECISION


No.

Sub Unit's Code : None Date of : 01/03/2023


No. Appointment

Address of : United Precision,No.41a/9, 2nd Phase, Branch Office : BO - Peenya-I,Peenya-I, No.92,


Employer Peenya Ind,Opp Abb India Ltd 6th Main Road, Near State
Bank of Mysore, III Phase,

FAMILY DETAILS

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


with of Birth Address Aadhaar with IP
IP

Karnataka /
VENKATESH P Spouse 14/09/1969 NA / NA NA NA Yes

Bangalore

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Karnataka /
LAKSHMI C Dependant 01/01/1959 NA / NA NA NA Yes
mother
Bangalore

NOMINEE DETAILS

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

AS
VENKATESH P Spouse NA NA ABOVE,KarnatakaDist:Bangal 100
ore560096

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) : UNITED PRECISION


IP Number : 4941184015
Address : NO 64 2ND MAIN ROAD CROSS JAI BHUVANESWARI NAGAR,NANDINI
LAYOUT BANGALORE 560096,Dist:Bangalore,Karnataka
Date : 09/03/2023 7:06:33AM

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