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

The document is an e-Pehchan card for an employee named Ambanna, detailing personal, registration, employer, and family information. It includes the employee's insurance number, marital status, and addresses, as well as nominee details. The card serves as proof of registration under the ESI scheme and is necessary for availing cash and medical benefits.

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azeezrb
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20 views2 pages

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

The document is an e-Pehchan card for an employee named Ambanna, detailing personal, registration, employer, and family information. It includes the employee's insurance number, marital status, and addresses, as well as nominee details. The card serves as proof of registration under the ESI scheme and is necessary for availing cash and medical benefits.

Uploaded by

azeezrb
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 : AMBANNA Insurance No. : 5222376333


Date of Birth : 01/01/1975 UHID : AP01.0013489117
Gender : Male UAN : NA
Mobile Number : 8121171589 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 04/09/2025 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Married Name of Father / : balappa


Husband
Type Of Disability : NA
Present Address : 1-36,near govt primary Permanent Address : 1-36,near govt primary
school,malkapur,Dist:Vikarabad,Telangana school,malkapur,Dist:Vikarabad
,501158 ,Telangana,501158

Dispensary / : Golconda, AP (ESIS Disp.) Dispensary / : DCBO - Sadasivapeta, TS


IMP for IP IMP for Family (ESIC DCBO)

CURRENT EMPLOYER DETAILS

Employer's Code : 52000518830000999 Name of Employer : SINGH SECURITY SERVICES


No.

Sub Unit's Code : None Date of : 01/09/2025


No. Appointment

Address of : H NO 9-1-34/26 Branch Office : BO - Chikkadapalli,D.No


Employer BAPUNAGAR,LANGERHOUSE 6-4-4/8 Opp Gandhi hospital,
HYDERABAD,Dist:HyderabadTelangana5 DIMS premises, Musheerabad,

FAMILY DETAILS

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


with of Birth Address Aadhaar with IP
IP

Page 1 of 2
NOMINEE DETAILS

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

1-34,NEAR GOVT PRIMARY


BALAPPA Dependant father NA NA SCHOOL,TANDUR,Telangan 100
aDist:Vikarabad

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) : SINGH SECURITY SERVICES


IP Number : 5222376333
Address : 1-36,near govt primary school,malkapur,Dist:Vikarabad,Telangana,501158

Date : 04/09/2025 11:58:58

Page 2 of 2

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