Scribd
Upload
90 views

M Srinivas

This document contains personal and employment details for an individual named M SRINIVAS who is insured under the Employees' State Insurance Corporation (ESIC) scheme. It lists his name, date of birth, insurance number, current employer, and family details. It also notes that this e-Pehchan card containing his family photograph can be requested for availing cash or medical benefits under the ESIC scheme.

Uploaded by

Prince Kumar Azad
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
90 views

M Srinivas

This document contains personal and employment details for an individual named M SRINIVAS who is insured under the Employees' State Insurance Corporation (ESIC) scheme. It lists his name, date of birth, insurance number, current employer, and family details. It also notes that this e-Pehchan card containing his family photograph can be requested for availing cash or medical benefits under the ESIC scheme.

Uploaded by

Prince Kumar Azad
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : M SRINIVAS Insurance No. : 5220257130


Date of Birth : 01/05/1988 UHID : NA
Gender : Male UAN : NA
Mobile Number : 8585500000 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 07/11/2023 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : CHANDRAIAH


Husband
Type Of Disability : NA
Present Address : krishnapur,Dist:Sangareddy,Telangana,502 Permanent Address : krishnapur,Dist:Sangareddy,Tel
246 angana,502246

Dispensary / : Zaheerabad, AP (ESIS Disp.) Dispensary / : Zaheerabad, AP (ESIS Disp.)


IMP for IP IMP for Family

CURRENT EMPLOYER DETAILS

Employer's Code : 34000492640000911 Name of Employer : MYTEK INNOVATIONS


No. PRIVATE LIMITED

Sub Unit's Code : 52340492640010911 Date of : 07/11/2023


No. Appointment

Address of : plot no 47, veema reddy colony,,allipur, Branch Office : BO - Patancheru,H No 14-26 /
Employer zaheerabad,,Dist:SangareddyTelangana5 1 & 2, 2nd foor, G R R Vijaya
Plaza,Above Andhra Bank,

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

krishnapur,TelanganaDist:Sa
CHANDRAIAH Dependant father NA NA ngareddy 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) : MYTEK INNOVATIONS PRIVATE LIMITED


IP Number : 5220257130
Address : krishnapur,Dist:Sangareddy,Telangana,502246

Date : 07/11/2023 2:34:55PM

Page 2 of 2

You might also like