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

This document contains personal and employment details for P SRI HARISH KUMAR who is registered with the Employees' State Insurance Corporation (ESIC) social security program. It provides his insurance number, date of birth, employer information including the employer code and address. It also lists family member details including his father Ponraj N and mother Bhuvaneshwari P. The document serves as an e-Pehchan card to avail cash and medical benefits under the ESIC scheme.

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0034-l-SRI HARISH KUMAR P
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© © All Rights Reserved
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Download as PDF, TXT or read online on Scribd
2K views

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

This document contains personal and employment details for P SRI HARISH KUMAR who is registered with the Employees' State Insurance Corporation (ESIC) social security program. It provides his insurance number, date of birth, employer information including the employer code and address. It also lists family member details including his father Ponraj N and mother Bhuvaneshwari P. The document serves as an e-Pehchan card to avail cash and medical benefits under the ESIC scheme.

Uploaded by

0034-l-SRI HARISH KUMAR P
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 2

EMPLOYEES' STATE INSURANCE CORPORATION

e-Pehchan Card

PERSONAL DETAILS

Name of IP : P SRI HARISH KUMAR Insurance No. : 5134873300


Date of Birth : 08/07/2005 UHID : NA
Gender : Male UAN : NA
Mobile Number : 8124328425 ABHA Number : NA
Email ID : NA ABHA Address : NA
Registration Date : 11/07/2023 Aadhaar : NA

REGISTRATION DETAILS

Marital Status : Unmarried Name of Father / : Ponraj N


Husband
Type Of Disability : NA
Present Address : No.426 Sakthi Nagar 3rd Cross Permanent Address : No.426 Sakthi Nagar 3rd Cross
Street,Poonthandalam,Dist:Chennai,Tamiln Street,Poonthandalam,Dist:Che
adu,600069 nnai,Tamilnadu,600069

Dispensary / : Thirumudivakkam, TN (ESIS Disp.) Dispensary / : Thirumudivakkam, TN (ESIS


IMP for IP IMP for Family Disp.)

CURRENT EMPLOYER DETAILS

Employer's Code : 51001388520000699 Name of Employer : CONCRETE OEM PRIVATE


No. LIMITED

Sub Unit's Code : None Date of : 10/07/2023


No. Appointment

Address of : Sf No-186 And 188,Erikarai Branch Office : BO - Poonamallee


Employer Road,Kolacherry Village (Kanchipuram),ESI Corporation,
Dhanasu Building,
NA no.l A, Trunk

FAMILY DETAILS

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


with of Birth Address Aadhaar with IP
IP

Tamilnadu /
Ponraj N Dependant 20/06/1979 NA Yes
father
Chennai

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Tamilnadu /
Bhuvaneshwari P Dependant 05/12/1985 NA Yes
mother
Chennai

NOMINEE DETAILS

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

426, Sakthi Nagar 3rd Cross


Ponraj N Dependant father NA NA Street,Poonthandalam,Tamil 100
naduDist:Chennai600069

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) : CONCRETE OEM PRIVATE LIMITED


IP Number : 5134873300
Address : No.426 Sakthi Nagar 3rd Cross
Street,Poonthandalam,Dist:Chennai,Tamilnadu,600069
Date : 11/07/2023 11:21:19AM

Page 2 of 2

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