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User Login: 66000465780001020
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EMPLOYEES' STATE INSURANCE CORPORATION
e-Pehchan Card
Insured Person : BRJESH KUMAR
Insurance No. : 6634155702
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: BRJESH KUMAR Type of Disability: NA
Name of Father /
sahaj ram Date of Birth: 01/01/1997
Husband:
Marital Status: Unmarried Gender: Male
jamdan,Dist:Bahraich,Uttar
Present Address: muthiahpuram,Dist:Thoothukudi,Tamilnadu,628005 Permanent Address:
Pradesh,271803
Dispensary / IMP for
Dispensary / IMP for IP: Tuticorin, TN (ESIS Disp.) Tuticorin, TN (ESIS Disp.)
Family:
UHID: DL01.0007381525 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
Percentage
Name of Nominee Relationship with IP Date of Birth UHID/ABHA Number Address of Nominee
Allotted
jamdan,Uttar
sahaj ram Dependant father NA NA 100
PradeshDist:Bahraich271803
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. :
9458465689
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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