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Employees' State Insurance Corporation E-Pehchan Card: Personal Details

The document is an e-Pehchan card for an employee named Priyanka, who is registered under the Employees' State Insurance Corporation with insurance number 1327970365. It includes personal details, current employer information, and family details, indicating her marital status as married and her spouse's name as Jatin. The card serves as proof of registration under the ESI scheme, with eligibility for benefits dependent on contribution conditions.

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vikas.y
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8 views2 pages

Employees' State Insurance Corporation E-Pehchan Card: Personal Details

The document is an e-Pehchan card for an employee named Priyanka, who is registered under the Employees' State Insurance Corporation with insurance number 1327970365. It includes personal details, current employer information, and family details, indicating her marital status as married and her spouse's name as Jatin. The card serves as proof of registration under the ESI scheme, with eligibility for benefits dependent on contribution conditions.

Uploaded by

vikas.y
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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EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : PRIYANKA Insurance No. : 1327970365


Date of Birth : 16/07/1999 UHID : HR01.0013008383
Gender : Female UAN : NA
Mobile Number : 8814052862 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 05/06/2025 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : Jatin


Husband
Type Of Disability : NA
Present Address : House No. 3581,Gali No 15 Mani Permanent Address : House No. 3581,Gali No 15
Ram,Dist:Hissar,Haryana,125001 Mani
Ram,Dist:Hissar,Haryana,1250
01
Dispensary / : Hisar Road, Hansi, HR (ESIS Disp.) Dispensary / : Hisar Road, Hansi, HR (ESIS
IMP for IP IMP for Family Disp.)

CURRENT EMPLOYER DETAILS

Employer's Code : 69000467550001401 Name of Employer : EYE Q VISION PVT. LTD.


No.

Sub Unit's Code : 13690467550011401 Date of : 27/05/2025


No. Appointment

Address of : Eye-Q Super Speciality Eye Hospitals,,In Branch Office : BO - Hissar,Opp Haryana Tin
Employer Association with Gayatri Eye Factory, IDC Hissar,125001
Hospital,,Jindal Chowk, Hisar,

FAMILY DETAILS

Name Relation Date UHID/ABHA Number ABHA UAN/ Is Residing State/District


with of Birth Address Aadhaar with IP
IP

Haryana /
Jatin Spouse 26/08/2000 HR01.0013008384/N / NA NA NA Yes
A
Hissar

Page 1 of 2
NOMINEE DETAILS

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

House No. 3581,Gali No 15


Jatin Spouse NA NA Mani 100
Ram,HaryanaDist:Hissar125
001

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) : EYE Q VISION PVT. LTD.


IP Number : 1327970365
Address : House No. 3581,Gali No 15 Mani Ram,Dist:Hissar,Haryana,125001

Date : 05/06/2025 11:22:09PM

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