4406788293

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EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : AKHILESH CHAUHAN Insurance No. : 4406788293


Date of Birth : 10/10/1983 UHID : NA
Gender : Male UAN : NA
Mobile Number : 9621588262 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 10/04/2024 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : RAM NARESH CHAUHAN


Husband
Type Of Disability : NA
Present Address : SHRAMIK Permanent Address : PURADAKHILA,PURA
VIHAR,NISHA,Dist:Angul,Odisha,759130 DAKHILA,Dist:Deoria,Uttar
Pradesh,274505

Dispensary / : Angul, OR (ESIS Disp.) Dispensary / : DCBO - Amethi


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 : 09/04/2024


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

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NOMINEE DETAILS

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

SAME,Uttar
RAMBHA DEVI Spouse NA NA PradeshDist:Deoria 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) : TATA PROJECTS LIMITED


IP Number : 4406788293
Address : SHRAMIK VIHAR,NISHA,Dist:Angul,Odisha,759130

Date : 11/04/2024 8:17:25PM

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