ODISHA BUILDING AND OTHER CONSTRUCTION WORKERS' WELFARE BOARD,
BHUBANESWAR.
CONSTRUCTION WORKER IDENTITY CARD
FORM XXVIII
[See Rule 266(1)]
Registration Number : ODPUR001145301 Date of Registration : 21-11-2024
Name : BAIKUNTHA BEHERA
Sex : Male
Date of Birth : 01/01/1971
Marital Status : Married
Father’s Name : BHARAT BEHERA
Spouse Name : BIMALA BEHERA
Permanent Address : DEKHTA PURI Bank Details : Acc no: 48070100005801
SUNUGORADI 752114 Bank name: BANK OF BARODA
Branch name: HARISHPUR
IFSC: BARB0HARISP
Present Address : DEKHATA PURI Religion : Hindu
SUNUGORADI 752114
Category : OBC
Physically Challenged : NO Nature of job : Mason(Mistri)
NFSA/SFSA Card No :
Interstate migrant worker : NO Signature valid
Signature of the worker : Signed by : SANTOSH
KUMAR MOHANTY Date
Place : PURI : 21-11-2024
Date : 21-Nov-2024
13:08:08
Registration Valid Up to : 20-Nov-2027 Santosh Kumar Mohanty
Annual Contribution last : Registering Officer
paid on District Labour Office Puri
Note:- i This is a digitally signed electronically generated certificate and therefore needs no ink-signed signature.
ii This certificate is issued as per section 4, 5 & 6 of IT Act, 2000 and its subsequent amendments in 2008.
iii For verification, visit https://nirmanshramik.odisha.gov.in.
iv Tampering of this certificate will attract penal action.
v The card holder may download new updated identity card from his/ her own login dashboard in the onlineportal on expiry of validity
periodsubject to regular payment of Annual Contribution for renewal.D
