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Manoj Kumar

The document is a registration detail for an e-Pehchan Card issued by the Employees' State Insurance Corporation for an insured person named Manoj Kumar. It includes personal information such as his insurance number, date of birth, marital status, and employer details. Additionally, it outlines family and nominee details along with instructions for retaining the document for future reference.

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rishabhsahu87400
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55 views1 page

Manoj Kumar

The document is a registration detail for an e-Pehchan Card issued by the Employees' State Insurance Corporation for an insured person named Manoj Kumar. It includes personal information such as his insurance number, date of birth, marital status, and employer details. Additionally, it outlines family and nominee details along with instructions for retaining the document for future reference.

Uploaded by

rishabhsahu87400
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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12/11/24, 11:27 AM CounterFoilPage

User Wednesday, December 11, 2024


Login: 21000604500000999 11:27:40 AM

EMPLOYEES' STATE INSURANCE CORPORATION


e-Pehchan Card

Insured Person : MANOJ KUMAR


Insurance No. : 2113419561
Date of Registration : 11/12/2024
YOUR REGISTRATION DETAILS
Please seed Universal Account Number (UAN)
Employee Name: MANOJ KUMAR Type of Disability: NA
Name of Father / Husband: hira lal Date of Birth: 01/04/1985
Marital Status: Married Gender: Male
mirzapur,Dist:Mirzapur,Uttar mirzapur,Dist:Mirzapur,Uttar
Present Address: Pradesh
Permanent Address: Pradesh
Bhathapara, Baloda Bazar, CT Bhathapara, Baloda Bazar, CT
Dispensary / IMP for IP: (ESIS Disp.)
Dispensary / IMP for Family: (ESIS Disp.)
UHID: NA ABHA Number: NA
UAN: NA EmailID: NA
ABHA Address: NA Aadhaar: NA
Employer's Code No.: 21000604500000999 Employer's Code No.: None
Sub Unit's Code No.: None Sub Unit's Code No.: None
Date of Appointment: 11/12/2024 First Insurance No.: None
TRIVENI CONSTRUCTION AND
Name of Employer: REFRACTORIES
Name of Employer: None
87 Chak Imam
Address of Employer: Ali,Naini,Naini,Dist:AllahabadUttar Address of Employer: None
Pradesh211008

Family Details

Relationship with UHID/ABHA ABHA Whether Place of


Name Date of Birth UAN/Aadhaar
the Employee Number Address Residing with IP Residence
State District
--- --- --- --- --- --- --- ---
Nominee Details
Percentage
Name of Nominee Relationship with IP Date of Birth UHID/ABHA Number Address of Nominee
Allotted
hira lal Dependant father NA NA MIRZAPUR,Uttar 100
PradeshDist:Mirzapur
Documents none
Uploaded:

BO - Allahabad,40F/18, Ist Floor, P.D.Tondon Road, Civil Lines,Allahabad-211001,0


Affix Your Family Photograph Here.(Attested and Stamped by Employer /
ESIC Official)
Signature / LTI of
Registered
Employee / IP :

Mobile No. :
9451054854

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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