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Employees' State Insurance Corporation E-Pehchan Card: Personal Details

esic card

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crmgroups1986
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8 views2 pages

Employees' State Insurance Corporation E-Pehchan Card: Personal Details

esic card

Uploaded by

crmgroups1986
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
Download as pdf or txt
Download as pdf or txt
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EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : M MEGHANA Insurance No. : 4941667618


Date of Birth : 28/09/1999 UHID : KA01.0013169638
Gender : Female UAN : NA
Mobile Number : 9535431172 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 06/08/2024 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : DILEEP YADAV B M


Husband
Type Of Disability : NA
Present Address : SHIVAPURA MAIN ROAD Permanent Address : SHIVAPURA MAIN ROAD
NELAGATARAHALLI,BANGALORE,Dist:B NELAGATARAHALLI,BANGAL
angalore,Karnataka ORE,Dist:Bangalore,Karnataka

Dispensary / : Peenya, KA (ESIS Disp.) Dispensary / : Peenya, KA (ESIS Disp.)


IMP for IP IMP for Family

CURRENT EMPLOYER DETAILS

Employer's Code : 49000368900001019 Name of Employer : CRM GROUPS


No.

Sub Unit's Code : None Date of : 01/08/2024


No. Appointment

Address of : 134/34, CHAMUNDIPURA, 8th A Branch Office : BO - Peenya-I,Peenya-I, No.92,


Employer CROSS,,NEAR MANJUNATHA PARK, 6th Main Road, Near State
Bank of Mysore,
NA III Phase,

FAMILY DETAILS

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


with of Birth Address Aadhaar with IP
IP

Karnataka /
DILEEP YADAV B Spouse 11/05/1991 KA01.0013169639/N NA Yes
M A
Bangalore

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NOMINEE DETAILS

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

PEENYA
DILEEP YADAV B Spouse NA NA BANGLORE,KarnatakaDist: 100
M Bangalore

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) : CRM GROUPS


IP Number : 4941667618
Address : SHIVAPURA MAIN ROAD
NELAGATARAHALLI,BANGALORE,Dist:Bangalore,Karnataka
Date : 06/08/2024 1:52:36PM

Page 2 of 2

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