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Insured Person: VIDYANAND KUMAR Insurance No.: 6634155639 Date of Registration: 27/12/2024

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0% found this document useful (0 votes)
40 views1 page

Insured Person: VIDYANAND KUMAR Insurance No.: 6634155639 Date of Registration: 27/12/2024

Uploaded by

info
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CounterFoilPage https://portal.esic.gov.in/InsuranceGlobalWebV7//Employee/CounterF...

Friday, 27 December, 2024 1:52:49


User Login: 66000465780001020
PM

EMPLOYEES' STATE INSURANCE CORPORATION


e-Pehchan Card

Insured Person : VIDYANAND KUMAR


Insurance No. : 6634155639
Date of Registration : 27/12/2024
Medical Acceptance Card [Click Here to View Medical Acceptance Card]
YOUR REGISTRATION DETAILS
Please seed Universal Account Number (UAN)
Employee Name: VIDYANAND KUMAR Type of Disability: NA
Name of Father /
pramod thakur Date of Birth: 17/08/1996
Husband:
Marital Status: Unmarried Gender: Male
Present Address: muthiahpuram,Dist:Thoothukudi,Tamilnadu,628005 Permanent Address: tintanga,Dist:Bhagalpur,Bihar,853205
Dispensary / IMP for Dispensary / IMP for
Tuticorin, TN (ESIS Disp.) Tuticorin, TN (ESIS Disp.)
IP: Family:
UHID: NA ABHA Number: NA
UAN: NA EmailID: NA
ABHA Address: NA Aadhaar: NA
Employer's Code No.: 66000465780001020 Employer's Code No.: None
Sub Unit's Code No.: None Sub Unit's Code No.: None
Date of Appointment: 27/12/2024 First Insurance No.: None
Name of Employer: RR.VASIKARAN AND COMPANY Name of Employer: None
3/128 B-26,Perinba
Address of Employer: Address of Employer: None
Nagar,Muthiahpuram,Dist:ThoothukudiTamilnadu628005

Family Details

Relationship with UHID/ABHA ABHA Whether Residing Place of


Name Date of Birth UAN/Adhaar
the Employee Number Address with IP Residence
State District
--- --- --- --- --- --- --- ---
Nominee Details
UHID/ABHA Percentage
Name of Nominee Relationship with IP Date of Birth Address of Nominee
Number Allotted
pramod thakur Dependant father NA NA tintanga,BiharDist:Bhagalpur853205 100
Documents
none
Uploaded:

BO - Tuticorin,ESI Corporation Branch Office,No. 164-N, North Beach Road, Tuticorin – 628 001,628001
Affix Your Family Photograph Here.(Attested and Stamped by Employer /
Signature / ESIC Official)
LTI of
Registered
Employee /
IP :

Mobile No. :
8465265486

NOTE:

1. Please keep this printout for future reference and bring this along with your Photo ID Card for all your claim benefits and medical benefits.
2. This copy should be retained with you until the Pehchan Card is received.
3. Employer to please affix employee and his family photo here and attest with official stamp across.

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1 of 1 27-12-2024, 13:49

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